MEDICARE: DR. LOUIS THOMAS LAPORTA JR. PSYD

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
1	103T00000X	Psychologist	PY5882	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609986900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOUIS THOMAS LAPORTA JR. PSYD

Provider Business Mailing Address
First Line	:	18920 US HIGHWAY 41
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34610-2244
Country	:	US
Telephone Number	:	727-836-0943
Fax Number	:	720-293-0098

Provider Business Practice Location Address
First Line	:	18920 US HIGHWAY 41
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34610-2244
Country	:	US
Telephone Number	:	727-836-0943
Fax Number	:	720-293-0098

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	01/26/2022

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