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General NPI Number Information
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NPI Number | 1316209455
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Entity Type | Organization
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Legal Business Name | APPLIED SCIENCES AND KNOWLEDGE FOR MENTAL DISORDERS PA
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Dates
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Enumeration Date | 06/14/2012
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Last Update Date | 06/15/2012
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Provider Practice Location Address
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Address Line | 555 RANCH RD
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City | TARPON SPRINGS
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State | FL
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Zip | 34688-9027
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Country | US
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Telephone | 727-271-3988
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Fax |
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Provider Business Mailing Address
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Address Line | 555 RANCH RD
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City | TARPON SPRINGS
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State | FL
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Zip | 34688-9027
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Country | US
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Telephone | 727-271-3988
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. WILLIAM LAURENTE CUA
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Credential | M.D.
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Telephone | 727-271-3988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME63065
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License Number State | FL
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