Doctor Name: | DR. ALEXANDER T GIMON |
NPI Number: | 1033307053 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D |
License Number: | 002952 |
Business Practice Address: | 10225 Ulmerton Rd Blg.#12 B Largo, FL - 337713538 |
Business Phone Number: | 7275841551 |
Business Fax Number: | 7275815107 |
Mailing Address: | 10225 Ulmerton Rd, Blg.#12 B LARGO |
State: | FL |
Postal Code: | 337713538 |
Phone Number: | 7275841551 |
Fax Number: | 7275815107 |
NPI Enumeration Date: | 10/04/2007 |
NPI Last Update Date: | 10/04/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 002952 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |