Healthcare Provider Details

I. General information

NPI: 1699945394
Provider Name (Legal Business Name): JOHN J DABROWSKI PHD P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2008
Last Update Date: 11/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13357 N 56TH ST
TAMPA FL
33617-1161
US

IV. Provider business mailing address

13357 N 56TH ST
TAMPA FL
33617-1161
US

V. Phone/Fax

Practice location:
  • Phone: 813-983-0190
  • Fax: 813-983-0247
Mailing address:
  • Phone: 813-983-0190
  • Fax: 813-983-0247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY5294
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPY5294
License Number StateFL

VIII. Authorized Official

Name: DR. JOHN J DABROWSKI
Title or Position: PRESIDENT
Credential: PHD
Phone: 813-983-0190