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Organization

PSYCHIATRY SERVICES OF OSCEOLA LLC

Active
Parent organization
PSYCHIATRY SERVICES OF OSCEOLA LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
PSYCHIATRY SERVICES OF OSCEOLA LLC
Authorized official
WILLIAM TEDRICK JOHNSON (VICE PRESIDENT)
(615) 372-3375
Entity
Organization

Contact information

Practice address
810 N ROSE AVE, KISSIMMEE, FL 34741-4944
(407) 847-0113
Mailing address
2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4692
(615) 372-5426

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary

Other

Enumeration date
10/27/2021
Last updated
10/27/2021
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