Provider Demographics
NPI:1922411263
Name:GPSPNP LLC
Entity Type:Organization
Organization Name:GPSPNP LLC
Other - Org Name:GPS
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:MCDONOUGH
Authorized Official - Suffix:III
Authorized Official - Credentials:PHD
Authorized Official - Phone:813-495-4773
Mailing Address - Street 1:2216 SHADEHILL CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-5044
Mailing Address - Country:US
Mailing Address - Phone:813-495-4773
Mailing Address - Fax:813-935-4771
Practice Address - Street 1:2216 SHADEHILL CT
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-5044
Practice Address - Country:US
Practice Address - Phone:813-495-4773
Practice Address - Fax:813-935-4771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-04
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty