| John Hendershot, Ph.d., P.a. | |
|
5221 Ehrlich Rd Suite A Tampa FL 33624-2006 | |
| (813) 265-4811 | |
| (813) 277-0202 |
| Full Name | John Hendershot, Ph.d., P.a. |
|---|---|
| Speciality | Psychologist |
| Location | 5221 Ehrlich Rd, Tampa, Florida |
| Authorized Official Name and Position | John Hendershot (PRESIDENT) |
| Authorized Official Contact | 8132654811 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John Hendershot, Ph.d., P.a. 5221 Ehrlich Rd Ste A Tampa FL 33624-2006 Ph: (813) 265-4811 | John Hendershot, Ph.d., P.a. 5221 Ehrlich Rd Suite A Tampa FL 33624-2006 Ph: (813) 265-4811 |
| NPI Number | 1134293343 |
|---|---|
| Provider Enumeration Date | 11/20/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6305013517 |
|---|---|
| Medicare Enrollment ID | O20120111000384 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134293343 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY4314 (Florida) | Primary |
| Provider Name | John T Hendershot |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386813376 PECOS PAC ID: 0749457950 Enrollment ID: I20120111000412 |
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