Healthcare Provider Details

I. General information

NPI: 1124953872
Provider Name (Legal Business Name): PRISCILLA ATAA AMOFA-HO PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3515 E FLETCHER AVE
TAMPA FL
33613-4706
US

IV. Provider business mailing address

12901 BRUCE B DOWNS BLVD
TAMPA FL
33612-4742
US

V. Phone/Fax

Practice location:
  • Phone: 813-905-1049
  • Fax:
Mailing address:
  • Phone: 813-905-1049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number13213
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: