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General NPI Number Information
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NPI Number | 1568309383
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Entity Type | Organization
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Legal Business Name | TAMPA AUTISM DIAGNOSTIC CENTER LLC
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Dates
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Enumeration Date | 04/30/2026
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Last Update Date | 04/30/2026
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Provider Practice Location Address
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Address Line | 18952 N DALE MABRY HWY STE 102
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City | LUTZ
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State | FL
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Zip | 33548-4916
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Country | US
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Telephone | 954-701-5808
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 47045
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City | TAMPA
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State | FL
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Zip | 33646-0109
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Country | US
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Telephone | 954-701-5808
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MAURICE MORRIS
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Credential |
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Telephone | 954-701-5808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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