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Contact Information

LEESBURG PSYCHOLOGY
8529 US HIGHWAY 441
LEESBURG, FL34788-4021
 Phone: 352-787-7144
 Fax: 352-450-7600
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for LEESBURG PSYCHOLOGY

NPI Number 1710204292
LBN Legal business name LEESBURG PSYCHOLOGY
Authorized official EVELYN BAEZ-ROJAS - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/23/2010
Last updated 05/10/2010 - About 16 years ago
Identifiers
FL License # PY4794
FL Other 59515 BLUE CROSS AND BLUE SHIELD OF FLORIDA
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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