Organization
PROFESSIONAL PSYCHIATRIC ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IFTIKHAR RASUL M.D (PRESIDENT)
(863) 206-0015
Entity
Organization
Contact information
Practice address
2545 PARTRIDGE DR, WINTER HAVEN, FL 33884-3033
(863) 206-0015
Mailing address
2545 PARTRIDGE DR, WINTER HAVEN, FL 33884-3033
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
ME88613
FL
251S00000X
Community/Behavioral Health Agency
Primary
ME88613
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43193Z
—
FL
Enumeration date
02/13/2014
Last updated
02/13/2014
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