| Professional Psychological Services Of Florida | |
|
15525 Starling Crossing Dr Lithia FL 33547-4021 | |
| (813) 351-9235 | |
| Not Available |
| Full Name | Professional Psychological Services Of Florida |
|---|---|
| Speciality | Psychologist |
| Location | 15525 Starling Crossing Dr, Lithia, Florida |
| Authorized Official Name and Position | Robert Joseph Klukoff (PSYCHOLOGIST) |
| Authorized Official Contact | 8133519235 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Psychological Services Of Florida Po Box 441 Lithia FL 33547-0441 Ph: (813) 351-9235 | Professional Psychological Services Of Florida 15525 Starling Crossing Dr Lithia FL 33547-4021 Ph: (813) 351-9235 |
| NPI Number | 1821629593 |
|---|---|
| Provider Enumeration Date | 01/30/2020 |
| Last Update Date | 02/10/2020 |
| Certification Date | 02/10/2020 |
| Medicare PECOS PAC ID | 9133540339 |
|---|---|
| Medicare Enrollment ID | O20200526001131 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821629593 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Robert Klukoff |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104130335 PECOS PAC ID: 2062536691 Enrollment ID: I20100902000621 |
| Provider Name | Nanette Frankel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194312884 PECOS PAC ID: 4789098245 Enrollment ID: I20210126000122 |
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