| Hopebridge Llc | |
|
6909 Old Highway 441 S Ste 119 Mount Dora FL 32757-7039 | |
| (352) 358-5001 | |
| (317) 520-8200 |
| Full Name | Hopebridge Llc |
|---|---|
| Speciality | Psychologist |
| Location | 6909 Old Highway 441 S Ste 119, Mount Dora, Florida |
| Authorized Official Name and Position | Stephen Louis Dicarlo (CREDENTIALING TEAM LEAD) |
| Authorized Official Contact | 8553240885 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hopebridge Llc 3500 Depauw Blvd Ste 3070 Indianapolis IN 46268-6135 Ph: (855) 324-0885 | Hopebridge Llc 6909 Old Highway 441 S Ste 119 Mount Dora FL 32757-7039 Ph: (352) 358-5001 |
| NPI Number | 1568118370 |
|---|---|
| Provider Enumeration Date | 03/02/2022 |
| Last Update Date | 03/02/2022 |
| Certification Date | 03/02/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568118370 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
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