Provider Demographics
| NPI: | 1265287312 |
|---|---|
| Name: | MENTAL HEALTH FIRST |
| Entity type: | Organization |
| Organization Name: | MENTAL HEALTH FIRST |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | PSYCHIATRIST |
| Authorized Official - Prefix: | DR |
| Authorized Official - First Name: | ROBERT |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | WATKINS |
| Authorized Official - Suffix: | III |
| Authorized Official - Credentials: | MD |
| Authorized Official - Phone: | 407-664-8242 |
| Mailing Address - Street 1: | 1177 LOUISIANA AVE STE 209 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | WINTER PARK |
| Mailing Address - State: | FL |
| Mailing Address - Zip Code: | 32789-2352 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 407-664-8242 |
| Mailing Address - Fax: | 407-960-6284 |
| Practice Address - Street 1: | 1177 LOUISIANA AVE STE 209 |
| Practice Address - Street 2: | |
| Practice Address - City: | WINTER PARK |
| Practice Address - State: | FL |
| Practice Address - Zip Code: | 32789-2352 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 407-664-8242 |
| Practice Address - Fax: | 407-960-6284 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2024-04-22 |
| Last Update Date: | 2024-04-22 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 2084P0804X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry | Group - Single Specialty |