| NPI | 1740158872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK E HICKEY President 727-504-7073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2025-10-29 |
| Last Update Date | 2025-11-06 |