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Organization

ORLANDO INTEGRATIVE MENTAL HEALTH PLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PRAVEEN CHANDRA PATHAK MD (MANAGING MEMBER)
(412) 608-2576
Entity
Organization

Contact information

Practice address
1485 S SEMORAN BLVD BLDG 6, SUITE 1454, WINTER PARK, FL 32792-5533
(407) 671-2258
(407) 671-2675
Mailing address
1485 S SEMORAN BLVD BLDG 6, SUITE 1454, WINTER PARK, FL 32792-5533
(407) 671-2258
(407) 671-2675

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME102076
FL
2084P0804X
Child & Adolescent Psychiatry Physician
ME102076
FL

Other

Enumeration date
09/23/2010
Last updated
09/23/2010
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