GULFSIDE PSYCHOLOGY INC (NPI# 1861026569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861026569 |
| Entity Type | Organization |
| Organization Name | GULFSIDE PSYCHOLOGY INC |
| Practice Address |
3902 E State Road 64 Bradenton FL 34208-9059 |
| Mailing Address |
5614 Cloverleaf Run Bradenton FL 34211-4048 |
| Practice Telephone | 9412433005 |
| Practice Fax Number | 9417399358 |
| Mailing Telephone | 8602504488 |
| Mailing Fax Number | 9417399358 |
| Enumeration Date | 2020-03-03 |
| Last Update Date | 2020-08-05 |
| Authorized Official Name | MR. JOHN K MCDERMOTT (PRESIDENT) |
| Authorized Official Telephone | 9412433005 |
| Authorized Official Credential | OWNER |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | Behavioral Health & Social Service Providers |
| Street Address |
3902 E STATE ROAD 64 |
| City | BRADENTON |
| State | FL |
| Zip Code | 34208-9059 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689106262 | Stephanie Feil Johnson | Clinical Neuropsychologist | 3902 E State Road 64, Bradenton, FL 34208-9059 | 2017-04-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740880566 | Michael Gerard Kulikowski | Pharmacist | 6225 E Sr 64, Bradenton, FL 34208 | 2020-10-30 |
| 1104431964 | Genesis Carrillo | Pharmacist | 4210 E, Fl-64, Bradenton, FL 34208 | 2020-09-09 |
| 1962960146 | Elite Surgery Center, LLC | Plastic Surgery | 5301 4th Ave Circle E, Bradenton, FL 34208 | 2019-03-07 |
| 1740777101 | Chinelo Uche | Student in an Organized Health Care Education/Training Program | 206 2nd St. E, Brandenton, FL 34208 | 2018-04-20 |
| 1396240040 | Nicholas Guy Ross | Student in an Organized Health Care Education/Training Program | 206 2nd St E., Bradenton, FL 34208 | 2018-03-26 |
| 1881196566 | Pinnacle Dental, Inc | Dentist | 5220 4th Ave. Circle E., Bradenton, FL 34208 | 2018-03-08 |
| 1194240176 | Bradenton Community Acupuncture | Acupuncturist | 5245 Office Park Blvd Suite 103, Bradenton, FL 34208 | 2017-08-10 |
| 1316490147 | Loretta Michele Deloach | Counselor | 515 27th St. S., Ste. 3, Bradenton, FL 34208 | 2016-07-28 |
| 1730548934 | Elodie Chimuanya Epane Kamdem | Dentist | Bright Now Dentalst, 650, 3611 1st Street, Suiyr, Bradenton, FL 34208 | 2016-02-16 |
| 1215303920 | Lesley Ann White | Driver | 45 Palmwood, Bradenton, FL 34208 | 2015-08-17 |
| Find all providers in zip 34208 | ||||
| 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 |
|---|---|---|---|---|
| 1689106262 | Stephanie Feil Johnson | Clinical Neuropsychologist | 3902 E State Road 64, Bradenton, FL 34208-9059 | 2017-04-01 |
| 1699820613 | Tashawna K Duncan | Clinical Neuropsychologist | 5245 Office Park Blvd, Suite 105, Bradenton, FL 34203-3444 | 2007-01-23 |
| 1891850772 | Michael B Spellman | Clinical Neuropsychologist | 4835 27th St W, Suite 125, Bradenton, FL 34207-1768 | 2006-12-22 |
| 1821023797 | Denise K. Gross | Clinical Neuropsychologist | 6015 111th St E, Bradenton, FL 34211-9468 | 2006-07-11 |
| 1811982598 | James M Mcgovern | Clinical Neuropsychologist | 1023 Manatee Ave W Ste 302, Bradenton, FL 34205-7816 | 2005-09-19 |
| 1023003886 | David James Hobbs | Clinical Neuropsychologist | 2110 58th St W, Bradenton, FL 34209-5660 | 2005-09-16 |
| 1316963077 | Pinnacle Medical Group Pa | Clinical Neuropsychologist | 315 75th St W, Bradenton, FL 34209-3201 | 2006-07-15 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.