MOSAICO MENTAL HEALTH CENTER CORP (NPI# 1114575636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114575636 |
| Entity Type | Organization |
| Organization Name | MOSAICO MENTAL HEALTH CENTER CORP |
| Practice Address |
12315 Lake Underhill Rd Ste B Orlando FL 32828-4507 |
| Practice Telephone | 4079300050 |
| Practice Fax Number | 4077514804 |
| Mailing Telephone | 4079300050 |
| Mailing Fax Number | 4077514804 |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2020-03-31 |
| Authorized Official Name | GUSTAVO V RUIZ SANTIAGO (DOCTOR) |
| Authorized Official Telephone | 7875055114 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | PENDING | 05 |
| Street Address |
12315 LAKE UNDERHILL RD STE B |
| City | ORLANDO |
| State | FL |
| Zip Code | 32828-4507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578057501 | Antonia Mejia | Social Worker | 15260 Sugargrove Way, Orlando, FL 32828 | 2018-06-22 |
| 1871087692 | Comfortable Care Dental Health Professionals, P.a. | Dentist | 3502 Avalon Park East Blvd, Orlando, FL 32828 | 2018-06-15 |
| 1386169738 | Ashley Nicole Wilkins | Specialist/Technologist | 2653 Wembleycross Way, Orlando, FL 32828 | 2017-08-07 |
| 1558812388 | Porta Nova Homemaker Companion Services, LLC | In Home Supportive Care | 515 Spring River Drive, Orlando, FL 32828 | 2016-10-17 |
| 1467908715 | Alexander Duque | Dentist | 785 N Alafaya Trail, Orlando, FL 32828 | 2016-08-28 |
| 1568819886 | Nicole Kircher | Behavioral Analyst | 757 Sterling Springs Rd, Orlando, FL 32828 | 2016-05-17 |
| 1477908556 | Sandra Maria Garcia | Speech-Language Pathologist | 4961 Atwood Dr, Orlando, FL 32828 | 2016-04-26 |
| 1821473380 | Sandra Ware | Physical Therapy Assistant | 498 Palm Springs Dr, Ste 345, Orlando, FL 32828 | 2015-07-27 |
| 1649674367 | Lisa M Keough | Occupational Therapist | 447 Bella Vida Blvd., Creative Speech Solutions & Therapy, Orlando, FL 32828 | 2014-10-09 |
| 1336549781 | Melissa Cossu | Developmental Therapist | 14428 Turning Leaf Dr, Orlando, FL 32828 | 2014-09-03 |
| Find all providers in zip 32828 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326602566 | Lake Nona Psychiatric Associates, LLC | Psychiatry & Neurology | 8511 Adalina Pl, Orlando, FL 32827-7277 | 2019-04-23 |
| 1063986461 | Sunshine Premier Wellness Center LLC | Psychiatry & Neurology | 4365 Hunters Park Ln # 50, Orlando, FL 32837-7614 | 2019-01-18 |
| 1578918462 | Sbm Medical Services, LLC. | Psychiatry & Neurology | 14225 Ludgate Hill Ln, Orlando, FL 32828-7921 | 2016-04-27 |
| 1487919932 | Luis Javier Olivera-rodriguez | Psychiatry & Neurology | 6001 Vineland Rd Ste 109, Orlando, FL 32819-7829 | 2012-07-11 |
| 1568627701 | Bay Hill Psychiatric Associates LLC | Psychiatry & Neurology | 2869 Wilshire Dr Ste 203, Orlando, FL 32835-3282 | 2008-07-28 |
| 1598932378 | The Gutman Pain/accident Center, Inc | Psychiatry & Neurology | 301 N Fern Creek Ave, Orlando, FL 32803-5400 | 2008-05-12 |
| 1750407680 | Samuel Sidney Mcclure | Psychiatry & Neurology | 504 N.wymore Rd., Orlando, FL 32789 | 2007-03-22 |
| 1801912894 | Aysha Meloukheia | Psychiatry & Neurology | 422 S Alafaya Trail Suite 17, Orlando, FL 32828 | 2007-03-21 |
| 1962542282 | Earl Paul Taitt Jr. | Psychiatry & Neurology | 4151 Hunters Park Lane, Suite 100, Orlando, FL 32837-7690 | 2007-02-07 |
| 1811047996 | Richard Carter-torres | Psychiatry & Neurology | 6735 Conroy Rd Ste 221, Orlando, FL 32835-3570 | 2007-01-11 |
| Find all providers in ORLANDO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.