Provider Demographics
NPI:1750429965
Name:SUBERVI, FELIX JOSEPH III (PHD)
Entity type:Individual
Prefix:MR
First Name:FELIX
Middle Name:JOSEPH
Last Name:SUBERVI
Suffix:III
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:201 N MACDILL AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-1523
Mailing Address - Country:US
Mailing Address - Phone:813-876-1832
Mailing Address - Fax:813-876-0133
Practice Address - Street 1:201 N MACDILL AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-1523
Practice Address - Country:US
Practice Address - Phone:813-876-1832
Practice Address - Fax:813-876-0133
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5313103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical