Organization
MOFFITT CANCER CENTER & RESEARCH INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL B. JACOBSEN PHD (CHAIR, HEALTH OUTCOMES & BEHAVIOR)
(813) 745-1810
Entity
Organization
Contact information
Practice address
12902 USF MAGNOLIA DR, TAMPA, FL 33612-9416
(813) 745-3862
(813) 745-3906
Mailing address
12902 USF MAGNOLIA DR, TAMPA, FL 33612-9416
(813) 745-3862
(813) 745-3906
Taxonomy
Speciality
Code
Description
License number
State
284300000X
Special Hospital
Primary
PY 5272
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PY5272
CLINICAL PSYCHOLOGY LICENSE
FL
Enumeration date
12/02/2009
Last updated
12/03/2009
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