Organization
BEHAVIORAL MEDICINE & PSYCHOTHERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUIS MANUEL VINUELA MD (MANAGER)
(321) 704-3042
Entity
Organization
Contact information
Practice address
2340 DAIRY RD, SUITE 104, MELBOURNE, FL 32904-5246
(321) 327-5952
(321) 327-5954
Mailing address
2401 W EAU GALLIE BLVD STE 1, MELBOURNE, FL 32935-2765
(321) 327-5952
(321) 327-5954
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME94555
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710943311
NPI
FL
Enumeration date
07/01/2008
Last updated
06/06/2023
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