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General NPI Number Information
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NPI Number | 1073617551
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Entity Type | Organization
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Legal Business Name | SUNCOAST PSYCHOMETRICS, INC
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 73 S PALM AVE STE 215
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City | SARASOTA
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State | FL
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Zip | 34236-5612
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Country | US
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Telephone | 941-921-5181
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Fax | 941-922-4091
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Provider Business Mailing Address
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Address Line | 73 S PALM AVE STE 215
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City | SARASOTA
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State | FL
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Zip | 34236-5612
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Country | US
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Telephone | 941-921-5181
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Fax | 941-922-4091
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Authorized Official
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Title or Position | PRESIDENT,CE
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Name | DR. DONALD A. MCMURRAY
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Credential | PH.D.
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Telephone | 941-921-5181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | PY 4631
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License Number State | FL
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