| Johnnie B Byrd Sr Alzheimers Center And Research Institute | |
|
4001 E Fletcher Ave Tampa FL 33613-4808 | |
| (813) 866-1611 | |
| (813) 866-1612 |
| Full Name | Johnnie B Byrd Sr Alzheimers Center And Research Institute |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4001 E Fletcher Ave, Tampa, Florida |
| Authorized Official Name and Position | Lilly Ho - Pehling (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 8138661610 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Johnnie B Byrd Sr Alzheimers Center And Research Institute 4001 E Fletcher Ave Tampa FL 33613-4808 Ph: (813) 866-1611 | Johnnie B Byrd Sr Alzheimers Center And Research Institute 4001 E Fletcher Ave Tampa FL 33613-4808 Ph: (813) 866-1611 |
| NPI Number | 1972700169 |
|---|---|
| Provider Enumeration Date | 06/29/2007 |
| Last Update Date | 07/15/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972700169 | NPI | - | NPPES |
| ME31300 | Other | FL | BALEBAIL ASHOK RAJ, M.D. |
| SW 7429 | Other | FL | NANCY ANN TETEN, LCSW,CAP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW 7429 (Florida) | Primary |
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | ME31300 (Florida) | Secondary |
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