| Potential Psychological Services Corp | |
|
13220 Scharber Rd Dade City FL 33525-8008 | |
| (352) 588-5135 | |
| Not Available |
| Full Name | Potential Psychological Services Corp |
|---|---|
| Speciality | Social Worker |
| Location | 13220 Scharber Rd, Dade City, Florida |
| Authorized Official Name and Position | Daryl D. Bozone (PRESIDENT) |
| Authorized Official Contact | 3525885135 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Potential Psychological Services Corp 13220 Scharber Rd Dade City FL 33525-8008 Ph: (352) 588-5135 | Potential Psychological Services Corp 13220 Scharber Rd Dade City FL 33525-8008 Ph: (352) 588-5135 |
| NPI Number | 1992186399 |
|---|---|
| Provider Enumeration Date | 06/11/2015 |
| Last Update Date | 06/11/2015 |
| Medicare PECOS PAC ID | 3072822766 |
|---|---|
| Medicare Enrollment ID | O20151020001889 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992186399 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW8851 (Florida) | Primary |
| Provider Name | Daryl D Bozone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003086489 PECOS PAC ID: 3375614654 Enrollment ID: I20080613000118 |
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