Organization
THE FEDORA PSYCHOLOGICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERTO ALVES PSY.D. (PRESIDENT)
(727) 209-7792
Entity
Organization
Contact information
Practice address
1913 TYRONE BLVD N, ST PETERSBURG, FL 33710-4841
(727) 282-5573
(813) 501-1173
Mailing address
PO BOX 49284, SAINT PETERSBURG, FL 33743-9284
(727) 209-7792
(813) 501-1173
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY 8491
FL
103TA0400X
Addiction (Substance Use Disorder) Psychologist
PY 8491
FL
103TB0200X
Cognitive & Behavioral Psychologist
PY 8491
FL
103TC0700X
Clinical Psychologist
PY 8491
FL
103TP2701X
Group Psychotherapy Psychologist
PY 8491
FL
Other
Enumeration date
12/18/2012
Last updated
05/13/2016
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