CENTER OF REVITALIZING PSYCHIATRY PC NPI 1538572854

NPI Information

NPI: 1538572854
Provider Name: CENTER OF REVITALIZING PSYCHIATRY PC
Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
2033 WOOD ST STE 220
SARASOTA, FL
ZIP 34237
Phone: (941) 677-3366
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CENTER OF REVITALIZING PSYCHIATRY PC is an adult mental health clinic center in Sarasota, FL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. CENTER OF REVITALIZING PSYCHIATRY PC NPI is 1538572854. The provider is registered as an organization entity type.

The provider's business location address is:

2033 WOOD ST STE 220
SARASOTA, FL
ZIP 34237-927
Phone: (941) 677-3366
Fax: (941) 677-3367

The provider's authorized official is Marina Tourkova .
The authorized official title is Medical Director and has the following contact phone number (941) 677-3366.

The enumeration date for this NPI number is 6/4/2014 and was last updated on 6/4/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0850X	Clinic/Center	Adult Mental Health	12-58-AD-4404-01	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	GA166A	MEDICARE PIN	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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