Provider Demographics
NPI:1386042190
Name:UNIVERSITY OF FLORIDA
Entity Type:Organization
Organization Name:UNIVERSITY OF FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM CHAIR
Authorized Official - Prefix:DR
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSSING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-265-7981
Mailing Address - Street 1:8491 NW 39TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-5635
Mailing Address - Country:US
Mailing Address - Phone:352-265-8858
Mailing Address - Fax:
Practice Address - Street 1:8491 NW 39TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-5635
Practice Address - Country:US
Practice Address - Phone:352-265-8858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-10
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY-9197103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty