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NPI Code Detail

MEDICARE: DR. DAVID E. NATHANSON PH.D

MEDICARE:  DR. DAVID E. NATHANSON  PH.D
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
1103TM1800XIntellectual & Developmental Disabilities PsychologistPY 3839FL

General Provider Information

NPI Number : 1316247208
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID E. NATHANSON PH.D
Provider Business Mailing Address
First Line : 5012 WESLEY DR
Second Line :
City : TAMPA
State : FL
Zip : 33647-1375
Country : US
Telephone Number : 813-971-6026
Fax Number : 813-971-6026
Provider Business Practice Location Address
First Line : 5012 WESLEY DR
Second Line :
City : TAMPA
State : FL
Zip : 33647-1375
Country : US
Telephone Number : 813-971-6026
Fax Number : 813-971-6026
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2010
Last Update Date : 10/26/2010

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Directions to “ DR. DAVID E. NATHANSON PH.D” Practice Location

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