Mind Revive Psychiatry Llc - Medicare Mental Health Clinic in Auburndale, FL

Mind Revive Psychiatry Llc is a medicare enrolled mental health clinic (Nurse Practitioner) in Auburndale, Florida. The current practice location for Mind Revive Psychiatry Llc is 1863 Skyview Dr, Auburndale, Florida. For appointments, you can reach them via phone at (407) 561-2500. The mailing address for Mind Revive Psychiatry Llc is Po Box 640, Auburndale, Florida and phone number is (407) 561-2500.

Mind Revive Psychiatry Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1285230185. 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 (407) 561-2500.

Contact Information

Mind Revive Psychiatry Llc
1863 Skyview Dr
Auburndale
FL 33823-5445
(407) 561-2500
Not Available

Mental Health Clinic Profile

Full NameMind Revive Psychiatry Llc
SpecialityNurse Practitioner
Location1863 Skyview Dr, Auburndale, Florida
Authorized Official Name and PositionMarcus L Robinson (PSYCHIATRIC NURSE PRACTITIONER)
Authorized Official Contact8633992664
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mind Revive Psychiatry Llc
Po Box 640
Auburndale
FL 33823-0640

Ph: (407) 561-2500
Mind Revive Psychiatry Llc
1863 Skyview Dr
Auburndale
FL 33823-5445

Ph: (407) 561-2500

NPI Details:

NPI Number1285230185
Provider Enumeration Date12/07/2020
Last Update Date08/22/2023
Certification Date08/22/2023

Medicare PECOS Information:

Medicare PECOS PAC ID7618382151
Medicare Enrollment IDO20210216001983

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Medical Identifiers

Medical identifiers for Mind Revive Psychiatry Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1285230185NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QM0801XClinic/center - Mental Health (including Community Mental Health Center) (* (Not Available))Secondary
261QM0855XClinic/center - Adolescent And Children Mental Health (* (Not Available))Secondary
363L00000XNurse Practitioner (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Mind Revive Psychiatry Llc acts as a billing entity for following providers:
Provider NameMarcus L Robinson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1740736537
PECOS PAC ID: 0547540247
Enrollment ID: I20161215002312

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