| Gulf Coast Neuropsychology, Llc | |
|
2650 Bahia Vista St Suite 201 Sarasota FL 34239-2635 | |
| (941) 993-3074 | |
| (941) 722-3039 |
| Full Name | Gulf Coast Neuropsychology, Llc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 2650 Bahia Vista St, Sarasota, Florida |
| Authorized Official Name and Position | Shaun Kelley O'neal (OWNER) |
| Authorized Official Contact | 9419933074 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gulf Coast Neuropsychology, Llc 2650 Bahia Vista St Suite 201 Sarasota FL 34239-2635 Ph: (941) 993-3074 | Gulf Coast Neuropsychology, Llc 2650 Bahia Vista St Suite 201 Sarasota FL 34239-2635 Ph: (941) 993-3074 |
| NPI Number | 1972039584 |
|---|---|
| Provider Enumeration Date | 05/03/2017 |
| Last Update Date | 06/05/2017 |
| Medicare PECOS PAC ID | 6204106362 |
|---|---|
| Medicare Enrollment ID | O20170721002058 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972039584 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | PY7351 (Florida) | Primary |
| Provider Name | Shaun K O'neal |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285644070 PECOS PAC ID: 0244230894 Enrollment ID: I20070119000312 |
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