| Kristin M. Phillips, Ph.d., Pllc | |
|
14448 Bruce B Downs Blvd Tampa FL 33613-2612 | |
| (813) 701-2471 | |
| (813) 701-2471 |
| Full Name | Kristin M. Phillips, Ph.d., Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 14448 Bruce B Downs Blvd, Tampa, Florida |
| Authorized Official Name and Position | Kristin M. Phillips (MANAGER) |
| Authorized Official Contact | 8137012471 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kristin M. Phillips, Ph.d., Pllc 14448 Bruce B Downs Blvd Tampa FL 33613-2612 Ph: (813) 701-2471 | Kristin M. Phillips, Ph.d., Pllc 14448 Bruce B Downs Blvd Tampa FL 33613-2612 Ph: (813) 701-2471 |
| NPI Number | 1114669033 |
|---|---|
| Provider Enumeration Date | 04/11/2022 |
| Last Update Date | 04/11/2022 |
| Certification Date | 04/11/2022 |
| Medicare PECOS PAC ID | 7113314410 |
|---|---|
| Medicare Enrollment ID | O20220504001937 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114669033 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Kristin M Phillips |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417210329 PECOS PAC ID: 0749446029 Enrollment ID: I20220504002094 |
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