| NPI | 1790023851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAMAR J INGULLI CEO/Neuropsychologist 813-381-5200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101Y00000X Counselor |
| 103G00000X Clinical Neuropsychologist | |
| 103TC0700X Psychologist, Clinical | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103TF0200X Psychologist, Forensic | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| Enumeration Date | 2013-01-24 |
| Last Update Date | 2021-10-25 |