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General NPI Number Information
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NPI Number | 1932253499
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Entity Type | Individual
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Provider Name | RONALD LOUIS PEAL PH.D
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Gender | Male
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5427 COMMERCIAL WAY
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City | SPRING HILL
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State | FL
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Zip | 34606-1110
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Country | US
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Telephone | 352-596-9616
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Fax | 352-592-2394
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Provider Business Mailing Address
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Address Line | PO BOX 24244
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City | TAMPA
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State | FL
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Zip | 33623-4244
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Country | US
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Telephone | 352-596-9616
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Fax | 352-592-2393
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY0003094
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License Number State | FL
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