Mid-florida Psychiatry Center Pl - Medicare Mental Health Clinic in Davenport, FL

Mid-florida Psychiatry Center Pl is a medicare enrolled mental health clinic (Clinic/center - Mental Health (including Community Mental Health Center)) in Davenport, Florida. The current practice location for Mid-florida Psychiatry Center Pl is 2504 Sand Mine Rd, Davenport, Florida. For appointments, you can reach them via phone at (863) 419-7645. The mailing address for Mid-florida Psychiatry Center Pl is 2504 Sand Mine Rd, Davenport, Florida and phone number is (863) 419-7645.

Mid-florida Psychiatry Center Pl is licensed to practice in Florida (license number ME82811). The clinic also participates in the medicare program and its NPI number is 1376599472. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (863) 419-7645.

Contact Information

Mid-florida Psychiatry Center Pl
2504 Sand Mine Rd
Davenport
FL 33897-3402
(863) 419-7645
Not Available

Mental Health Clinic Profile

Full NameMid-florida Psychiatry Center Pl
SpecialityClinic/Center
Location2504 Sand Mine Rd, Davenport, Florida
Authorized Official Name and PositionVidyasagar Reddy Vangala (MANAGER MEMBER)
Authorized Official Contact8634197645
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mid-florida Psychiatry Center Pl
2504 Sand Mine Rd
Davenport
FL 33897-3402

Ph: (863) 419-7645
Mid-florida Psychiatry Center Pl
2504 Sand Mine Rd
Davenport
FL 33897-3402

Ph: (863) 419-7645

NPI Details:

NPI Number1376599472
Provider Enumeration Date05/26/2006
Last Update Date11/22/2010

Medicare PECOS Information:

Medicare PECOS PAC ID4587808688
Medicare Enrollment IDO20130911000265

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Medical Identifiers

Medical identifiers for Mid-florida Psychiatry Center Pl such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1376599472NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QM0801XClinic/center - Mental Health (including Community Mental Health Center) ME82811 (Florida)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Mid-florida Psychiatry Center Pl acts as a billing entity for following providers:
Provider NameVidyasaga R Vangala
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1679568133
PECOS PAC ID: 4284685645
Enrollment ID: I20050203000255

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Provider NameEricka Stephens
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1598084428
PECOS PAC ID: 0749529311
Enrollment ID: I20190226000445

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Provider NameLisandra Castillo Llanes
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1467138420
PECOS PAC ID: 3678937174
Enrollment ID: I20230918001369

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Provider NameAnabel Ruiz
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1881373017
PECOS PAC ID: 6305291972
Enrollment ID: I20231017002539

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