Healthcare Provider Details

I. General information

NPI: 1881008308
Provider Name (Legal Business Name): WILLIAM L. HOGAN, MA.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2014
Last Update Date: 06/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 W BEARSS AVE SUITE B
TAMPA FL
33613-1228
US

IV. Provider business mailing address

14707 CARNATION DR
TAMPA FL
33613-1807
US

V. Phone/Fax

Practice location:
  • Phone: 888-899-7736
  • Fax: 954-366-2056
Mailing address:
  • Phone: 888-899-7736
  • Fax: 954-366-2056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM LEONARD HOGAN
Title or Position: MARRIAGE AND FAMILY THERAPIST
Credential: LMFT
Phone: 813-727-9616