Organization
FL PSYCHIATRIC SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUHANNAD KASSAWAT MD (OWNER)
(330) 965-9999
Entity
Organization
Contact information
Practice address
1 SE OCEAN BLVD, STUART, FL 34994-2214
(772) 400-2875
(772) 400-2876
Mailing address
PO BOX 3743, YOUNGSTOWN, OH 44513-3743
(330) 965-9999
(330) 757-0000
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
FL
Enumeration date
10/20/2020
Last updated
07/27/2021
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