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General NPI Number Information
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NPI Number | 1598267445
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Entity Type | Individual
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Provider Name | VINCENT MALIK DEHILI PH.D.
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Gender | Male
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Dates
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Enumeration Date | 03/07/2018
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Last Update Date | 06/22/2020
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Provider Practice Location Address
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Address Line | 146 2ND STREET NORTH SUITE 305
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City | ST. PETERSBURG
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State | FL
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Zip | 33701
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Country | US
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Telephone | 727-308-1180
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Fax |
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Provider Business Mailing Address
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Address Line | 1936 BRUCE B DOWNS BLVD PMB 174
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544
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Country | US
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Telephone | 813-816-2766
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | PY9919
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License Number State | FL
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