Organization
PIONEER PSYCHIATRY SERVICES LLC
Active
Parent organization
PIONEER MEDICAL GROUP, PL
Other names
Pioneer Psychiatry Services LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PIONEER MEDICAL GROUP, PL
Authorized official
SYED IRFAN ALI MD (PRESIDENT)
(813) 779-6303
Entity
Organization
Contact information
Practice address
13067 N TELECOM PKWY, TEMPLE TERRACE, FL 33637-0926
(813) 779-6303
Mailing address
13067 N TELECOM PKWY, TEMPLE TERRACE, FL 33637-0926
(813) 779-6303
(888) 977-1998
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0805X
Geriatric Psychiatry Physician
—
—
2084V0102X
Vascular Neurology Physician
—
—
363L00000X
Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
05/13/2019
Last updated
11/13/2019
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