Provider Demographics
NPI:1730198599
Name:MEDICAL ARTS PROFESSIONAL HEALTH SERVICES INC
Entity type:Organization
Organization Name:MEDICAL ARTS PROFESSIONAL HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PH.D.
Authorized Official - Prefix:
Authorized Official - First Name:THAIR
Authorized Official - Middle Name:R
Authorized Official - Last Name:DIEFFENBACH
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:352-683-0232
Mailing Address - Street 1:13215 SPRING HILL DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-5054
Mailing Address - Country:US
Mailing Address - Phone:352-683-0232
Mailing Address - Fax:352-683-0247
Practice Address - Street 1:13215 SPRING HILL DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-5054
Practice Address - Country:US
Practice Address - Phone:352-683-0232
Practice Address - Fax:352-683-0247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH0002734101YM0800X
FLME55252207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty