| Gulf Coast Psychology, Inc | |
|
5237 Summerlin Commons Blvd Suite 116 Fort Myers FL 33907-2158 | |
| (239) 274-7792 | |
| (239) 247-5344 |
| Full Name | Gulf Coast Psychology, Inc |
|---|---|
| Speciality | Psychologist |
| Location | 5237 Summerlin Commons Blvd, Fort Myers, Florida |
| Authorized Official Name and Position | Pasquale A Capozzoli (OWNER) |
| Authorized Official Contact | 2392747792 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gulf Coast Psychology, Inc 5237 Summerlin Commons Blvd Suite 116 Fort Myers FL 33907-2158 Ph: (239) 274-7792 | Gulf Coast Psychology, Inc 5237 Summerlin Commons Blvd Suite 116 Fort Myers FL 33907-2158 Ph: (239) 274-7792 |
| NPI Number | 1407281413 |
|---|---|
| Provider Enumeration Date | 09/09/2013 |
| Last Update Date | 08/10/2015 |
| Medicare PECOS PAC ID | 3072748268 |
|---|---|
| Medicare Enrollment ID | O20131023002092 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407281413 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY8575 (Florida) | Primary |
| Provider Name | Pasquale Angelo Capozzoli |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033467964 PECOS PAC ID: 4981839172 Enrollment ID: I20200429002975 |
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