Organization
CHILD AND ADOLESCENT TAMPA BAY PSYCHIATRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ONELIA RAMIREZ-COOK MD (MANAGER)
(813) 766-4218
Entity
Organization
Contact information
Practice address
100 S ASHLEY DR STE 600, TAMPA, FL 33602-5300
(813) 766-4218
Mailing address
12231 MAIN ST UNIT 1196, SAN ANTONIO, FL 33576-7253
(813) 440-2741
(813) 338-4490
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
ME112720
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00544800
—
FL
01
—
12662244
CAQH
—
01
—
1669639001
INDIVIDUAL NPI
—
01
—
2084P0800X
INDIVIDUAL TAXONOMY
—
01
—
ME112720
LICENSE NUMBER
FL
Enumeration date
09/07/2017
Last updated
09/07/2017
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