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Organization
MONROSE CLINIC ASSOCIATES FOR PSYCHOLOGICAL MEDICINE
Active
Organization
MONROSE CLINIC ASSOCIATES FOR PSYCHOLOGICAL MEDICINE
Active
Parent organization
MONROSE CLINIC ASSOCIATES FOR PSYCHOLOGICAL MEDICINE
Organization subpart
Yes
Provider details
NPI number
Legal business name
MONROSE CLINIC ASSOCIATES FOR PSYCHOLOGICAL MEDICINE
Authorized official
DR. ATUL M SHAH M.D. (PSYCHIATRISTS)
(904) 725-6463
Entity
Organization
Contact information
Practice address
3627 UNIVERSITY BLVD SOUTH SUITE 615, JACKSONVILLE, FL 32216-2721
(904) 725-6463
(904) 724-5006
Mailing address
3627 UNIVERSITY BLVD S STE 615, JACKSONVILLE, FL 32216-7401
(904) 725-6463
(904) 724-5006
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
ME0048902
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016627000
MAGELLAN
FL
05
—
043765400
—
FL
01
—
05770
WELLCARE
FL
01
—
081686072
TRICARE
FL
01
—
088657
VALUE OPTIONS
FL
01
—
14203
BLUE CROSS
FL
01
—
256262286A
GA. MEDICAID
GA
01
—
4115015
AETNA
FL
Enumeration date
03/11/2008
Last updated
09/17/2013
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