Provider Demographics
NPI:1437953759
Name:INTERACTIVE PSYCHIATRY LLC
Entity type:Organization
Organization Name:INTERACTIVE PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:TAIMARIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MAS MARANTE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN PMHNP-BC
Authorized Official - Phone:786-260-2702
Mailing Address - Street 1:10025 LAKE OAK CIR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-5287
Mailing Address - Country:US
Mailing Address - Phone:786-260-2702
Mailing Address - Fax:
Practice Address - Street 1:10025 LAKE OAK CIR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-5287
Practice Address - Country:US
Practice Address - Phone:786-260-2702
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty