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General NPI Number Information
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NPI Number | 1922334002
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Entity Type | Organization
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Legal Business Name | SUNCOAST NEUROPSYCHOLOGY LLC
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Dates
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Enumeration Date | 10/26/2009
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Last Update Date | 10/26/2009
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Provider Practice Location Address
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Address Line | 833 CYPRESS VILLAGE BLVD
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City | RUSKIN
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State | FL
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Zip | 33573-6822
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Country | US
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Telephone | 813-633-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 235 APOLLO BEACH BLVD # 506
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City | APOLLO BEACH
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State | FL
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Zip | 33572-2251
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Country | US
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Telephone | 813-633-6000
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Fax | 813-633-0438
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Authorized Official
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Title or Position | OWNER
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Name | DR. RHONDA MICHELLE ROSS
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Credential | PSYD
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Telephone | 813-633-6000
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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 | PY7611
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number | PY7611
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY7611
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | PY7611
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number | PY7611
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PY7611
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License Number State | FL
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