THE MEMORY DOCTOR, LLC (NPI# 1265434534) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265434534 |
| Entity Type | Organization |
| Organization Name | THE MEMORY DOCTOR, LLC |
| Practice Address |
26540 Ace Ave Ste E-106 Leesburg FL 34748-8279 |
| Mailing Address |
221 N Highway 27 Unit G Clermont FL 34711-2431 |
| Practice Telephone | 3525302170 |
| Practice Fax Number | 3525302180 |
| Mailing Telephone | 3522435901 |
| Mailing Fax Number | 3522434187 |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2019-07-24 |
| Authorized Official Name | BRENDA MASON (OFFICE MANAGER) |
| Authorized Official Telephone | 3525302170 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | PY6497 | FL | Behavioral Health & Social Service Providers |
| Y | 103G00000X | Clinical Neuropsychologist | PY6497 | FL | Behavioral Health & Social Service Providers |
| Street Address |
26540 ACE AVE STE E-106 |
| City | LEESBURG |
| State | FL |
| Zip Code | 34748-8279 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750383006 | Douglas J Mason | Clinical Neuropsychologist | 26540 Ace Ave Ste E-106, Leesburg, FL 34748-8279 | 2005-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437610243 | Ashley Shamsa Martin | Behavior Technician | 292 Bent Oak Ct, Leesburg, FL 34748 | 2019-03-26 |
| 1891278875 | Luis O Aponte Mendoza | Physician Assistant | 704 Doctors Ct., Suite 101, Leesburg, FL 34748 | 2018-09-14 |
| 1881197903 | Physician Associates LLC | Internal Medicine | 22316 Us Highway 27, Leesburg, FL 34748 | 2018-03-15 |
| 1184136145 | Infinite Support Services LLC | In Home Supportive Care | 129 Grove Ridge Circle, 104, Leesburg, FL 34748 | 2017-10-31 |
| 1619403037 | Massage and Wellness Care | Health Maintenance Organization | 1218 W. Dixie Ave, Suite A, Leesburg, FL 34748 | 2017-05-04 |
| 1497202675 | Prime Radiology of Leesburg Inc | Radiology | 600 N W Blvd, Suite E, Leesburg, FL 34748 | 2016-09-06 |
| 1023480332 | Juanita Elizabeth Simpson | Contractor | 1911 Harcourt Drive, Leesburg, FL 34748 | 2015-10-26 |
| 1467835900 | Serenity Choice Place, LLC | Community/Behavioral Health | 721 Balmoral Circle, Leesburg, FL 34748 | 2015-07-01 |
| 1356738397 | Touching Heart's Group Homes, LLC | Community/Behavioral Health | 31809 Sunpark Cir, Leesburg, FL 34748 | 2015-04-16 |
| 1386035269 | Adventist Health System/sunbelt, Inc. | Clinic/Center | 1103 N 14th Street, Leesburg, FL 34748 | 2015-02-12 |
| Find all providers in zip 34748 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750383006 | Douglas J Mason | Clinical Neuropsychologist | 26540 Ace Ave Ste E-106, Leesburg, FL 34748-8279 | 2005-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912512831 | Joshua Rooks, Phd, LLC | Clinical Neuropsychologist | 7328 Jacaranda Ln, Miami Lakes, FL 33014-2670 | 2020-09-09 |
| 1457978991 | Renew Psychiatric Care, LLC | Clinical Neuropsychologist | 3170 N Federal Hwy Ste 206b, Lighthouse Point, FL 33064-6720 | 2020-07-01 |
| 1871110460 | Thoughtwise LLC | Clinical Neuropsychologist | 2840 Remington Green Cir Ste 3, Tallahassee, FL 32308-1518 | 2020-06-29 |
| 1093338451 | Krizia Amy Vinck | Clinical Neuropsychologist | 1150 Nw 14th St, Miami, Fl 33136, Miami, FL 33136 | 2020-05-20 |
| 1124667795 | Jennifer Ann Barton | Clinical Neuropsychologist | 3411 Day Ave, Miami, FL 33133-5030 | 2019-12-31 |
| 1952947434 | Dagmar E Nunez | Clinical Neuropsychologist | 1351 Seagrape Cir, Weston, FL 33326-2726 | 2019-11-20 |
| 1821632779 | Joshua Daniel Rooks | Clinical Neuropsychologist | 6520 Miami Lakeway S, Miami Lakes, FL 33014-2747 | 2019-11-04 |
| 1427605088 | Global Wellness LLC | Clinical Neuropsychologist | 1560 Sawgrass Corporate Parkway #447, Sunrise, FL 33323 | 2019-08-19 |
| 1528627882 | Anchor Multispecialty Group | Clinical Neuropsychologist | 850 S Palafox St Unit 103, Pensacola, FL 32502-5983 | 2019-06-11 |
| 1639736473 | Aldrich Chan | Clinical Neuropsychologist | 2601 Sw 37th Ave Ste 703, Coral Gables, FL 33133-2750 | 2019-05-28 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.