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General NPI Number Information
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NPI Number | 1851451744
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Entity Type | Organization
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Legal Business Name | TIMOTHY TRIBIANO PHD PA
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 2401 W BAY DR BLDG 100 STE 117
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City | LARGO
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State | FL
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Zip | 33770-4900
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Country | US
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Telephone | 727-776-1968
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Fax | 727-289-2301
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Provider Business Mailing Address
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Address Line | 2401 W BAY DR BLDG 100 STE 117
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City | LARGO
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State | FL
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Zip | 33770-4900
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Country | US
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Telephone | 727-776-1968
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Fax | 727-289-2301
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Authorized Official
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Title or Position | OWNER
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Name | TIMOTHY TRIBIANO
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Credential | PHD
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Telephone | 727-776-1968
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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 | PY6773
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License Number State | FL
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