Teresa Irene Bobo

Primary specialty

Health PsychologistTaxonomy code 103TH0004X

License

4789 Issued in AZ

Practice address

10000 Bay Pines Blvd
Bay Pines VA Healthcare System
Bay Pines, FL 33744-8200

Phone

(727) 398-6661

NPI assigned

Jan 17, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Holistic Integrative Counseling Services

  • Adult Mental Health Clinic/Center
  • Orlando, FL
  • NPI 1477171965
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1437695202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 BAY PINES BLVD",
            "address_2": "BAY PINES VA HEALTHCARE SYSTEM",
            "city": "BAY PINES",
            "state": "FL",
            "postal_code": "337448200",
            "telephone_number": "727-398-6661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 BAY PINES BLVD",
            "address_2": "BAY PINES VA HEALTHCARE SYSTEM",
            "city": "BAY PINES",
            "state": "FL",
            "postal_code": "337448200",
            "telephone_number": "727-398-6661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBO",
        "first_name": "TERESA",
        "middle_name": "IRENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-17",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "4789",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "AZ",
            "license": "4789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larry Black, BCC-H/PC
• Laurie Ann Black, PH.D.
• Thomas J Black, MD
• Silvio E Blanco III, M.D.
• Dylan Ryan Blosser, PT, DPT
• Carolyn W Boddie, PHARMACIST
• Donna J Boman, ARNP
• Joy Bonelli
• Simone Boutros, DMD
• Elizabeth Diana Bowling, RD

• Health Psychologist in Bay Pines, FL
• Providers in Bay Pines, FL by specialty
• Health Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.