# IMAM PSYCHIATRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114750338
- **Authorized official:** MUHAMMAD NUMAAN IMAM NP (CEO/OWNER)
- **Authorized official phone:** (813) 580-0163

## Contact information

- **Practice address:** 466 WOODFORD DR, DEBARY, FL 32713-2145
- **Practice address phone:** (813) 580-0163
- **Mailing address:** 466 WOODFORD DR, DEBARY, FL 32713-2145
- **Mailing address phone:** (813) 580-0163

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 08/22/2024
- **Last updated:** 08/22/2024