Organization
SUNCOAST PEDIATRIC EPILEPSY AND NEUROPSYCHOLOGY SPECIALISTS
Active
Organization
SUNCOAST PEDIATRIC EPILEPSY AND NEUROPSYCHOLOGY SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YOLANDA LEON PSYD (OWNER)
(813) 633-6000
Entity
Organization
Contact information
Practice address
833 CYPRESS VILLAGE BLVD, RUSKIN, FL 33573-6822
(813) 633-6000
Mailing address
833 CYPRESS VILLAGE BLVD, RUSKIN, FL 33573-6822
(813) 633-6000
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY5685
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH036Z
MEDICARE
FL
Enumeration date
01/19/2010
Last updated
01/19/2010
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