Basic Information
| Provider Information | |||||||||
| NPI: | 1598088544 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PSYCHIATRIC CONSULTING, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1150 CAMPO SANO AVE | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | CORAL GABLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331461174 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3057797381 | ||||||||
| FaxNumber: | 3057797382 | ||||||||
| Practice Location | |||||||||
| Address1: | 1150 CAMPO SANO AVE | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | CORAL GABLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331461174 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3057797381 | ||||||||
| FaxNumber: | 3057797382 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/04/2010 | ||||||||
| LastUpdateDate: | 03/04/2010 | ||||||||
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| AuthorizedOfficialLastName: | PENALVER | ||||||||
| AuthorizedOfficialFirstName: | ALBERTO | ||||||||
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| AuthorizedOfficialTitleorPosition: | SECRETARY | ||||||||
| AuthorizedOfficialTelephone: | 3054018015 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | ME0060597 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.