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General NPI Number Information
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NPI Number | 1922942333
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Entity Type | Organization
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Legal Business Name | TAMPA NEUROPSYCHIATRY, LLC
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Dates
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Enumeration Date | 04/16/2026
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Last Update Date | 04/16/2026
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Provider Practice Location Address
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Address Line | 33920 US HIGHWAY 19 N STE 340
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City | PALM HARBOR
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State | FL
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Zip | 34684-2670
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Country | US
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Telephone | 813-995-1775
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 306637
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City | NASHVILLE
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State | TN
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Zip | 37230-6637
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | KIMBERLY GLAVESKAS
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Credential |
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Telephone | 214-550-7536
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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License Number |
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License Number State |
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