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NPI Code Detail

MEDICARE: MAUREEN CORBETT, PH.D., PA

MEDICARE: MAUREEN CORBETT, PH.D., PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologistPY 5441FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
154219OTHERFLBLUE CROSS BLUE SHIELD PROVIDER NUMBER

General Provider Information

NPI Number : 1033363924
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAUREEN CORBETT, PH.D., PA
Provider Business Mailing Address
First Line : 143 13TH AVE N
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33701-1103
Country : US
Telephone Number : 727-826-1887
Fax Number : 727-826-1887
Provider Business Practice Location Address
First Line : 840 BEACH DR NE
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33701-2012
Country : US
Telephone Number : 727-826-1887
Fax Number : 727-826-1887
Authorized Official
Title or Position : LICENSED PSYCHOLOGIST
Name : DR. MAUREEN MARY CORBETT
Credential : PH.D.
Telephone Number : 727-826-1887
Provider Enumeration Date : 11/05/2008
Last Update Date : 11/05/2008

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