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General NPI Number Information
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NPI Number | 1376104083
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Entity Type | Organization
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Legal Business Name | SHANNON CARAMIELLO, PSYD, LLC
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Dates
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Enumeration Date | 06/24/2019
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 2611 KEYSTONE RD STE B3
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City | TARPON SPRINGS
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State | FL
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Zip | 34688-7403
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Country | US
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Telephone | 727-597-0977
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Fax |
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Provider Business Mailing Address
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Address Line | 2611 KEYSTONE RD STE B3
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City | TARPON SPRINGS
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State | FL
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Zip | 34688-7403
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Country | US
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Telephone | 727-597-0977
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGICAL
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Name | SHANNON CARAMIELLO
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Credential | PSYD
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Telephone | 727-597-0977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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