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400 N Ashley Dr Ste 1900 Tampa FL 33602-4311 | |
| (888) 343-7222 | |
| (888) 791-0181 |
| Full Name | |
|---|---|
| Speciality | Behavior Analyst |
| Location | 400 N Ashley Dr Ste 1900, Tampa, Florida |
| Authorized Official Name and Position | Rosa Kuchling (CLIENT RELATIONS MANAGER) |
| Authorized Official Contact | 8883437222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
8270 Woodland Center Blvd Fl 2 Tampa FL 33614-2401 Ph: (888) 343-7222 | 400 N Ashley Dr Ste 1900 Tampa FL 33602-4311 Ph: (888) 343-7222 |
| NPI Number | 1639785645 |
|---|---|
| Provider Enumeration Date | 09/16/2020 |
| Last Update Date | 12/30/2024 |
| Certification Date | 12/30/2024 |
| Medicare PECOS PAC ID | 4981010220 |
|---|---|
| Medicare Enrollment ID | O20210310002211 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639785645 | NPI | - | NPPES |
| 111425200 | Medicaid | FL |
| Provider Name | Gema Yudit Der Rohe-borghese |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508263682 PECOS PAC ID: 6709292048 Enrollment ID: I20210310002311 |
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