Active NPI
Andrew Douglas Valdespino, PH.D.
- Clinical Psychologist
- Riverview, FL
National Provider Identifier
1144828971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY10921
- Practice address
- 12920 Summerfield Crossing Blvd
Riverview, FL 33579-7210 - Phone
- (813) 998-8600
- NPI assigned
- Oct 14, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY10921 | FL | Primary |
Addresses
Primary practice location
12920 Summerfield Crossing Blvd
Riverview, FL 33579-7210
Mailing address
9920 Jonas Salk Dr Apt 420
Riverview, FL 33578-7438
Phone (727) 512-7504
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY10921 | FL | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tampa Vamc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Department of Veterans Affairs (VA) Pharmacy
- Riverview, FL
- NPI 1821653080
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602633600000",
"number": "1144828971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9920 JONAS SALK DR APT 420",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335787438",
"telephone_number": "727-512-7504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12920 SUMMERFIELD CROSSING BLVD",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335797210",
"telephone_number": "813-998-8600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALDESPINO",
"first_name": "ANDREW",
"middle_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-14",
"last_updated": "2020-10-14",
"certification_date": "2020-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY10921",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverview, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.