Organization
NEWLIGHT PSYCHIATRIC SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PANCHAMI THOMAS ARNP (PRESIDENT)
(727) 424-8419
Entity
Organization
Contact information
Practice address
5302 S FLORIDA AVE STE 203, LAKELAND, FL 33813-4910
(863) 602-7001
Mailing address
2832 GALLAGHER RD, DOVER, FL 33527-5308
(727) 424-8419
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
ARNP9253922
FL
Other
Enumeration date
03/28/2018
Last updated
08/15/2024
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