| The Fedora Psychological Group, Llc | |
|
1913 Tyrone Blvd N St Petersburg FL 33710-4841 | |
| (727) 282-5573 | |
| (813) 501-1173 |
| Full Name | The Fedora Psychological Group, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1913 Tyrone Blvd N, St Petersburg, Florida |
| Authorized Official Name and Position | Roberto Alves (PRESIDENT) |
| Authorized Official Contact | 7272097792 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Fedora Psychological Group, Llc Po Box 49284 Saint Petersburg FL 33743-9284 Ph: (727) 209-7792 | The Fedora Psychological Group, Llc 1913 Tyrone Blvd N St Petersburg FL 33710-4841 Ph: (727) 282-5573 |
| NPI Number | 1285970277 |
|---|---|
| Provider Enumeration Date | 12/18/2012 |
| Last Update Date | 05/13/2016 |
| Medicare PECOS PAC ID | 5890084677 |
|---|---|
| Medicare Enrollment ID | O20160518000492 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285970277 | NPI | - | NPPES |
| Provider Name | Kristen M Sturdevant |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689879934 PECOS PAC ID: 9739316464 Enrollment ID: I20131230000089 |
| Provider Name | Roberto Alves |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235404724 PECOS PAC ID: 6709175581 Enrollment ID: I20160518000547 |
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