| Entity Name: | INSIGHT PSYCHIATRY OF FLORIDA LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 18 Apr 2023 (2 years ago) |
| Document Number: | L23000191050 |
| FEI/EIN Number | 923839011 |
| Address: | 950-23 BLANDING BLVD PMB 265, ORANGE PARK, FL, 32065, US |
| Mail Address: | 950-23 BLANDING BLVD PMB 265, ORANGE PARK, FL, 32065, US |
| ZIP code: | 32065 |
| County: | Clay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134818495 | 2023-05-03 | 2023-05-03 | 950 BLANDING BLVD BLDG SUITE23, ORANGE PARK, FL, 320655910, US | 3354 SEQUOIA RD, ORANGE PARK, FL, 320736622, US | |||||||||||||||||||||||||
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| Phone | +1 904-348-0061 |
| Phone | +1 904-805-3469 |
Authorized person
| Name | BRITTANY WILSON |
| Role | PMHNP-BC |
| Phone | 9048053469 |
Taxonomy
| Taxonomy Code | 261QM0850X - Adult Mental Health Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 261QM0855X - Adolescent and Children Mental Health Clinic/Center |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1386203818 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WILSON BRITTANY L | Agent | 950-23 BLANDING BLVD PMB 265, ORANGE PARK, FL, 32065 |
| Name | Role | Address |
|---|---|---|
| WILSON BRITTANY L | Authorized Member | 950-23 BLANDING BLVD PMB 265, ORANGE PARK, FL, 32065 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-08 |
| ANNUAL REPORT | 2024-01-16 |
| Florida Limited Liability | 2023-04-18 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
