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2216 Shadehill Ct Tampa FL 33612-5044 | |
| (813) 495-4773 | |
| (813) 935-4771 |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 2216 Shadehill Ct, Tampa, Florida |
| Authorized Official Name and Position | John P Mcdonough (MANAGER/OWNER) |
| Authorized Official Contact | 8134954773 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2216 Shadehill Ct Tampa FL 33612-5044 Ph: (813) 495-4773 | 2216 Shadehill Ct Tampa FL 33612-5044 Ph: (813) 495-4773 |
| NPI Number | 1922410539 |
|---|---|
| Provider Enumeration Date | 05/30/2014 |
| Last Update Date | 05/30/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922410539 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PY5741 (Florida) | Primary |
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