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Organization

S CURTIS TAKAGISHI PHD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. STANLEY CURTIS TAKAGISHI PH.D. (PRESIDENT)
(813) 690-8506
Entity
Organization

Contact information

Practice address
13331 N 56TH ST, TAMPA, FL 33617-1161
(813) 690-8506
Mailing address
10411 LIGHTNER BRIDGE DR, TAMPA, FL 33626-1815
(813) 690-8506

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY6420
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AF879
MEDICARE
Enumeration date
07/11/2006
Last updated
03/29/2012
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