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2109 E Palm Ave Ste 201 Tampa FL 33605 | |
| (813) 609-3699 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 2109 E Palm Ave Ste 201, Tampa, Florida |
| Authorized Official Name and Position | Gary L Howell (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 8134197793 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2109 E Palm Ave Ste 201 Tampa FL 33605-3909 Ph: (813) 419-7793 | 2109 E Palm Ave Ste 201 Tampa FL 33605 Ph: (813) 609-3699 |
| NPI Number | 1326340688 |
|---|---|
| Provider Enumeration Date | 11/18/2010 |
| Last Update Date | 07/21/2022 |
| Certification Date | 07/21/2022 |
| Medicare PECOS PAC ID | 1557547577 |
|---|---|
| Medicare Enrollment ID | O20120412000665 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326340688 | NPI | - | NPPES |
| 018464000 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Gary L Howell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699081943 PECOS PAC ID: 3577758796 Enrollment ID: I20120412000689 |
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