| NPI | 1922334002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA MICHELLE ROSS Owner 813-633-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: FL py7611) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL py7611) |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: FL py7611) | |
| 103TC0700X Psychologist, Clinical (Licence: FL PY7611) | |
| 103TF0200X Psychologist, Forensic (Licence: FL PY7611) | |
| 103TH0100X Psychologist, Health Service (Licence: FL PY7611) | |
| Enumeration Date | 2009-10-26 |
| Last Update Date | 2009-10-26 |