325 MDG (NPI# 1568436962) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568436962 |
| Entity Type | Organization |
| Organization Name | 325 MDG |
| Practice Address |
325 Mdg Bldg 1305 Suwannee Ave Tyndall Afb FL 32403 |
| Mailing Address |
2405 Maple Ct Panama City FL 32404-3047 |
| Practice Telephone | 8502837511 |
| Practice Fax Number | 8502837721 |
| Mailing Telephone | 8502837511 |
| Mailing Fax Number | 8502837721 |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2008-06-13 |
| Authorized Official Name | DR. GEORGE NICHOLAS JR. (325 MDG COMMANDER) |
| Authorized Official Telephone | 8502837515 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | PY5848 | FL | Behavioral Health & Social Service Providers |
| Street Address |
325 MDG BLDG 1305 SUWANNEE AVE |
| City | TYNDALL AFB |
| State | FL |
| Zip Code | 32403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326408063 | Nathaniel Criddle | Dentist | 325 Aerospace Medicine Sq/sgpd, 340 Magnolia Circle Bldg 1465, Tyndall Afb, FL 32403 | 2016-02-23 |
| 1952730491 | Erick Laron Jackson | Physical Therapist | 325 Mdg/physical Therapy, 340 Magnolia Circle, Tyndall Afb, FL 32403 | 2013-11-05 |
| 1972830701 | Quan Tram | Pharmacist | 340 Magnolia Cirlcle, Tyndall Afb, FL 32403 | 2009-11-16 |
| 1952473308 | Robert Allen Frick | Family Medicine | 325th Medical Group 340 Magnolia Circle, Tyndall Afb, Panama City, FL 32403 | 2006-11-14 |
| 1285733907 | 325th Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | Magnolia Circle, Tyndall Afb, FL 32403 | 2006-09-21 |
| 1093737272 | Walter Edward Calvo | Social Worker | Bldg 1305 Suwannee Ave, Tyndall Afb, FL 32403 | 2006-07-24 |
| 1790727865 | Michelle Gautreaux | Nutritionist | 325 Mdg, 340 Magnolia Circle, Tyndall Afb, FL 32403 | 2006-06-12 |
| 1780658005 | Brant Casford | Radiology | 325 Mdg/sgsar Radiology, Tyndall Afb, FL 32403 | 2006-02-14 |
| 1215911573 | Rama Bhyravabhotla | Physician Assistant | 325 Mdos/sgomf, 340 Magnolia Circle, Tyndall Afb, FL 32403 | 2005-12-01 |
| 1659355816 | Tracy Lynn Hunter | Specialist | Bldg 1404 Mississippi Rd, Panama City, FL 32403 | 2005-12-01 |
| Find all providers in zip 32403 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144774 | Jennifer Mcmanus | Psychologist | 4143 San Juan Ave, Jacksonville, FL 32210-3333 | 2020-11-03 |
| 1992304711 | Thomas Francis Ryan | Psychologist | 1015 Sonesta Ave, Brandon, FL 33511-6658 | 2020-10-22 |
| 1912506924 | Emily F. Hoon, Phd, Pllc | Psychologist | 2531 Nw 41st Street, Suite C, Gainesville, FL 32606-7490 | 2020-10-21 |
| 1447866405 | Daniel Martinez | Psychologist | 4765 W Atlantic Ave, Delray Beach, FL 33445-3838 | 2020-09-16 |
| 1134731367 | North Florida Neuropsychology, LLC | Psychologist | 1614 Mahan Center Blvd Ste 104, Tallahassee, FL 32308-5475 | 2020-08-19 |
| 1215547153 | Ellen Frances Price Phd | Psychologist | 7025 Beracasa Way Ste 102c, Boca Raton, FL 33433-3428 | 2020-08-05 |
| 1811515745 | Sarah Amelia Sanon | Psychologist | 10381 Sw 9th Ln, Pembroke Pines, FL 33025-3585 | 2020-07-07 |
| 1720606718 | Carolina Montalvo | Psychologist | 480 Ne 30th St Apt 1606, Miami, FL 33137-4337 | 2020-07-07 |
| 1689291833 | Bridget Cabibi | Psychologist | 10700 Nw 66th St Apt 512, Doral, FL 33178-5508 | 2020-07-02 |
| 1912524414 | Infinity Doctors Inc. | Psychologist | 9821 E Bay Harbor Dr Apt 401, Bay Harbor Islands, FL 33154-1868 | 2020-06-30 |
| Find all providers with the same taxonomy | ||||
| City | TYNDALL AFB |
| Zip Code | 32403 |
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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.