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General NPI Number Information
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NPI Number | 1437388915
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Entity Type | Organization
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Legal Business Name | BEN C. GHOZALI, PSY.D., P.A.
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Dates
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Enumeration Date | 07/06/2009
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Last Update Date | 09/10/2024
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Provider Practice Location Address
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Address Line | 2843 ALT 19
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City | PALM HARBOR
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State | FL
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Zip | 34683-1926
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Country | US
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Telephone | 727-772-0038
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Fax | 727-787-2384
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Provider Business Mailing Address
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Address Line | 2843 ALT 19
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City | PALM HARBOR
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State | FL
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Zip | 34683-1926
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Country | US
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Telephone | 727-772-0038
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Fax | 727-787-2384
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BEN GHOZALI
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Credential | PSY.D.
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Telephone | 813-215-8348
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY6738
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License Number State | FL
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