1962786483 NPI number — MILLENIA PSYCHIATRY & RESEARCH, INC.

Table of content: MRS. JENNIFER ANN HOSSAIN M.P.T. (NPI 1568684371)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962786483 NPI number — MILLENIA PSYCHIATRY & RESEARCH, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MILLENIA PSYCHIATRY & RESEARCH, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1962786483
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/20/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5323 MILLENIA LAKES BLVD
Provider Second Line Business Mailing Address:
#121
Provider Business Mailing Address City Name:
ORLANDO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32839-3392
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-830-0773
Provider Business Mailing Address Fax Number:
407-830-1366

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5323 MILLENIA LAKES BLVD
Provider Second Line Business Practice Location Address:
#121
Provider Business Practice Location Address City Name:
ORLANDO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32839-3392
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-830-0773
Provider Business Practice Location Address Fax Number:
407-830-1366
Provider Enumeration Date:
10/03/2011

Additional Information

Authorized Official

Authorized Official Last Name:
HAMZEHLOUI
Authorized Official First Name:
ROMEAN
Authorized Official Middle Name:
Authorized Official Title or Position:
GENERAL MANAGER
Authorized Official Telephone Number:
407-830-0773

Provider Taxonomy Codes

  • Taxonomy code: 2084P0804X , with the licence number:  ME21787 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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