MEDICARE: DR. TSILA ABUSH KIRSH 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
1	103TC0700X	Clinical Psychologist	PY6935	FL

General Provider Information

NPI Number	:	1891814364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TSILA ABUSH KIRSH PH.D.

Provider Business Mailing Address
First Line	:	15310 AMBERLY DR
Second Line	:	SUTIE 250
City	:	TAMPA
State	:	FL
Zip	:	33647-2199
Country	:	US
Telephone Number	:	813-312-1005
Fax Number	:	813-971-1477

Provider Business Practice Location Address
First Line	:	15310 AMBERLY DR
Second Line	:	SUTIE 250
City	:	TAMPA
State	:	FL
Zip	:	33647-2199
Country	:	US
Telephone Number	:	813-312-1005
Fax Number	:	813-971-1477

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	07/08/2007

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