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322 W Bearss Ave Tampa FL 33613-1228 | |
| (508) 369-4225 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 322 W Bearss Ave, Tampa, Florida |
| Authorized Official Name and Position | Gladys J Cano (MENTAL HEALTH THERAPIST) |
| Authorized Official Contact | 4019966011 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
8353 Eagle Brook Dr Land O Lakes FL 34638-2647 Ph: (401) 996-6011 | 322 W Bearss Ave Tampa FL 33613-1228 Ph: (508) 369-4225 |
| NPI Number | 1265163240 |
|---|---|
| Provider Enumeration Date | 06/21/2022 |
| Last Update Date | 02/12/2024 |
| Certification Date | 02/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265163240 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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