Thomas F. Guidera, PH.D, P.a.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY0003165 Issued in FL

Legal business name

THOMAS F. GUIDERA, PH.D, P.A.

Practice address

1777 Garden Street
Titusville, FL 32796-3221

Phone

(321) 268-5682

Fax

(321) 268-5683

NPI assigned

Jun 13, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Thomas F Guidera, PH.D., PANPI 1770647810

Title

Owner-Practitioner

Phone

(321) 268-5682

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas F Guidera, PH.D.

  • Clinical Psychologist
  • Titusville, FL
  • NPI 1770647810

  Clinical, FL

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1307923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337040000000",
    "number": "1013202571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 GARDEN STREET",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327963221",
            "telephone_number": "321-268-5682",
            "fax_number": "321-268-5683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 GARDEN STREET",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327963221",
            "telephone_number": "321-268-5682",
            "fax_number": "321-268-5683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS F. GUIDERA, PH.D, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-13",
        "last_updated": "2012-05-15",
        "status": "A",
        "authorized_official_last_name": "GUIDERA",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER-PRACTITIONER",
        "authorized_official_telephone_number": "321-268-5682",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., PA"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY 3165",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY0003165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CURRENT NPI",
            "identifier": "1770647810",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "75434",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Devereux Foundation
• The Devereux Foundation
• The Hospital Doulas & Associates LLC
• The Terrace of Titusville, LLC
• Amber Thibideau, LMT
• James M. Thomas, DDS
• Lisa Thomas
• Rachel Thomas I
• Sandi L Thomas, D.O.
• Terry Lee Thomas, M.S.

• All providers in Titusville, FL
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.