| James R Boone Ph D Professional Llc | |
|
2625 Keystone Rd Suite A-3 Tarpon Springs FL 34688-7436 | |
| (727) 944-4600 | |
| (727) 945-9800 |
| Full Name | James R Boone Ph D Professional Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2625 Keystone Rd, Tarpon Springs, Florida |
| Authorized Official Name and Position | James Richardson Boone (SOLE MEMBER) |
| Authorized Official Contact | 7279444600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| James R Boone Ph D Professional Llc 2625 Keystone Rd Suite A-3 Tarpon Springs FL 34688-7436 Ph: (727) 944-4600 | James R Boone Ph D Professional Llc 2625 Keystone Rd Suite A-3 Tarpon Springs FL 34688-7436 Ph: (727) 944-4600 |
| NPI Number | 1982814893 |
|---|---|
| Provider Enumeration Date | 05/23/2007 |
| Last Update Date | 12/14/2007 |
| Medicare PECOS PAC ID | 9638184732 |
|---|---|
| Medicare Enrollment ID | O20060210000285 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982814893 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY04361 (Florida) | Primary |
| Provider Name | James R Boone |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912114356 PECOS PAC ID: 3072528173 Enrollment ID: I20060213000037 |
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