| Center For Human Potential, P.a. | |
|
5301 Gulfport Blvd S Gulfport FL 33707-4947 | |
| (727) 894-9777 | |
| (727) 202-1010 |
| Full Name | Center For Human Potential, P.a. |
|---|---|
| Speciality | Psychologist |
| Location | 5301 Gulfport Blvd S, Gulfport, Florida |
| Authorized Official Name and Position | Joseph G Baum (PRESIDENT) |
| Authorized Official Contact | 7278949777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Human Potential, P.a. 5301 Gulfport Blvd S Gulfport FL 33707-4947 Ph: (727) 894-9777 | Center For Human Potential, P.a. 5301 Gulfport Blvd S Gulfport FL 33707-4947 Ph: (727) 894-9777 |
| NPI Number | 1588838510 |
|---|---|
| Provider Enumeration Date | 04/22/2008 |
| Last Update Date | 01/31/2015 |
| Medicare PECOS PAC ID | 8628227741 |
|---|---|
| Medicare Enrollment ID | O20121005000207 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588838510 | NPI | - | NPPES |
| 010152 | Other | FL | VALUE OPTIONS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY4190 (Florida) | Primary |
| Provider Name | Joseph Baum |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1508893249 PECOS PAC ID: 8628039765 Enrollment ID: I20041022000301 |
| Provider Name | Joseph Baum |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508893249 PECOS PAC ID: 8628039765 Enrollment ID: I20121005000238 |
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