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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