| NPI | 1518373521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE B AYALA-FELICIANO Clinical Psychologist 813-992-7050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TF0000X Psychologist, Family | |
| 103TH0100X Psychologist, Health Service | |
| 103TR0400X Psychologist, Rehabilitation | |
| Enumeration Date | 2014-07-10 |
| Last Update Date | 2025-08-18 |