Provider Demographics
NPI:1679337422
Name:FOCAL NEUROSCIENCE OF TAMPA BAY, LLC
Entity Type:Organization
Organization Name:FOCAL NEUROSCIENCE OF TAMPA BAY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:LORENA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-325-7479
Mailing Address - Street 1:6911 PISTOL RANGE RD STE 117
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33635-6340
Mailing Address - Country:US
Mailing Address - Phone:813-325-7479
Mailing Address - Fax:
Practice Address - Street 1:6911 PISTOL RANGE RD STE 117
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33635-6340
Practice Address - Country:US
Practice Address - Phone:813-325-7479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty