MEDICARE: GINA ZUCCOLO, PSY.D., P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC2200X	Clinical Child & Adolescent Psychologist	PY9735	FL

General Provider Information

NPI Number	:	1295276103
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GINA ZUCCOLO, PSY.D., P.A.

Provider Business Mailing Address
First Line	:	610 E ZACK ST STE 110-3002
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33602-3972
Country	:	US
Telephone Number	:	813-357-9612
Fax Number	:

Provider Business Practice Location Address
First Line	:	610 E ZACK ST STE 110-3002
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33602-3972
Country	:	US
Telephone Number	:	813-357-9612
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOLOGIST/OWNER
Name	:	GINA ZUCCOLO
Credential	:	PSY.D.
Telephone Number	:	813-357-9612

Provider Enumeration Date	:	03/10/2017
Last Update Date	:	06/11/2025

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