MONROSE CLINIC ASSOCIATES FOR PSYCHOLOGICAL MEDICINE NPI 1902076524

NPI Information

NPI: 1902076524
Provider Name: MONROSE CLINIC ASSOCIATES FOR PSYCHOLOGICAL MEDICINE
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
3627 UNIVERSITY BLVD SOUTH SUITE 615
JACKSONVILLE, FL
ZIP 32216
Phone: (904) 725-6463
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MONROSE CLINIC ASSOCIATES FOR PSYCHOLOGICAL MEDICINE is a mental health counselor in Jacksonville, FL. MONROSE CLINIC ASSOCIATES FOR PSYCHOLOGICAL MEDICINE NPI is 1902076524. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3627 UNIVERSITY BLVD SOUTH SUITE 615
JACKSONVILLE, FL
ZIP 32216-721
Phone: (904) 725-6463
Fax: (904) 724-5006

The provider's authorized official is Atul M Shah .
The authorized official title is Psychiatrists and has the following contact phone number (904) 725-6463.

The enumeration date for this NPI number is 3/11/2008 and was last updated on 9/17/2013.

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	101YM0800X	Counselor	Mental Health	ME0048902	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	088657	OTHER	FLORIDA	VALUE OPTIONS
2	14203	OTHER	FLORIDA	BLUE CROSS
3	4115015	OTHER	FLORIDA	AETNA
4	05770	OTHER	FLORIDA	UNITED BEHAVIORAL HEALTH
5	256262286A	OTHER	GEORGIA	GA. MEDICAID
6	14203	MEDICARE PIN	FLORIDA
7	081686072	OTHER	FLORIDA	FIRST HEALTH
8	081686072	OTHER	FLORIDA	CHAMPUS
9	016627000	OTHER	FLORIDA	MAGELLAN
10	05770	OTHER	FLORIDA	WELLCARE
11	081686072	OTHER	FLORIDA	TRICARE
12	14203	MEDICARE UPIN	FLORIDA
13	AQ526	MEDICARE PIN	FLORIDA
14	043765400	MEDICAID	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: 11/14/2023

NPI Synchronization or Removal

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