| Family Psychological Services Of Palm Harbor Inc | |
|
2142 Alt 19 Ste C1 Palm Harbor FL 34683-5361 | |
| (727) 787-6177 | |
| (727) 787-8406 |
| Full Name | Family Psychological Services Of Palm Harbor Inc |
|---|---|
| Speciality | Psychologist |
| Location | 2142 Alt 19 Ste C1, Palm Harbor, Florida |
| Authorized Official Name and Position | Eric L Rosen (OWNER & PRESIDENT) |
| Authorized Official Contact | 7277876177 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Psychological Services Of Palm Harbor Inc 2142 Alt 19 Ste C1 Palm Harbor FL 34683-5361 Ph: (727) 787-6177 | Family Psychological Services Of Palm Harbor Inc 2142 Alt 19 Ste C1 Palm Harbor FL 34683-5361 Ph: (727) 787-6177 |
| NPI Number | 1639203763 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 01/23/2024 |
| Certification Date | 01/23/2024 |
| Medicare PECOS PAC ID | 1759355191 |
|---|---|
| Medicare Enrollment ID | O20051122000407 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639203763 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PY5165 (Florida) | Primary |
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
| Provider Name | Eric L Rosen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184706376 PECOS PAC ID: 1456386929 Enrollment ID: I20051004000238 |
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