Basic Information
| Provider Information | |||||||||
| NPI: | 1225766793 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NATIONAL PSYCHIATRY, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2338 IMMOKALEE RD # 186 | ||||||||
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| City: | NAPLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 341101445 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2393302933 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6101 PINE RIDGE ROAD | ||||||||
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| City: | NAPLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 34119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2393302933 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2022 | ||||||||
| LastUpdateDate: | 08/11/2022 | ||||||||
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| AuthorizedOfficialLastName: | MARSH | ||||||||
| AuthorizedOfficialFirstName: | JONATHAN | ||||||||
| AuthorizedOfficialMiddleName: | W. | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2393302933 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 07/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.