Lake Mary Psychiatric Services LLC

NPI #1285679902 in Lake Mary, Florida

Provider Information

NPI Number: 1285679902
Entity Type: Organization
Organization Name: Lake Mary Psychiatric Services LLC
Primary Specialty: Specialist
Enumeration Date: Jun 17, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 101 TIMBERLACHEN CIR
Address 2: SUITE 201
City: Lake Mary
State: Florida
ZIP Code: 32746-6124
Phone: (407) 330-5818

Authorized Official

Name: MANUEL R. MOTA-CASTILLO, M.D.
Title: PSYCHIATRIC/MEDICAL DIRECTOR
Phone: (407) 330-5818

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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