Florida Psychological Specialists

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PY 7342 Issued in FL

Legal business name

FLORIDA PSYCHOLOGICAL SPECIALISTS

Practice address

1127 S Patrick Dr
Suite 1
Satellite Beach, FL 32937-3939

Phone

(321) 777-4440

Fax

(321) 777-4440

NPI assigned

Jul 24, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Demara Beth Bennett, PSY.D.

Title

Licensed Psychologist

Phone

(321) 777-4440

Specialties & licenses 3

Addresses

Other names 1

• DEMARA BENNETT SOLE MBR Other name

Locations

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

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215388800000",
    "number": "1639379928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 S PATRICK DR",
            "address_2": "SUITE 1",
            "city": "SATELLITE BEACH",
            "state": "FL",
            "postal_code": "329373939",
            "telephone_number": "321-777-4440",
            "fax_number": "321-777-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 S PATRICK DR",
            "address_2": "SUITE 1",
            "city": "SATELLITE BEACH",
            "state": "FL",
            "postal_code": "329373939",
            "telephone_number": "321-777-4440",
            "fax_number": "321-777-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA PSYCHOLOGICAL SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-24",
        "last_updated": "2008-07-07",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "DEMARA",
        "authorized_official_middle_name": "BETH",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "321-777-4440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY 7342",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 7342",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "FL",
            "license": "PY 7342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DEMARA BENNETT SOLE MBR",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Barbara Ann Edwards, APRN
• Kehinde Ekwotafia
• Courtney Eliott, MA42392
• Candace Ferguson, NP
• Florida Fall Prevention and Rehabilitation LLC
• Jasmine Foster
• From the Heart Florida
• From the Heart Florida LLC
• Melanie Fusco, CRNA
• James Gamblin III

• Clinical Child & Adolescent Psychologist in Satellite Beach, FL
• Providers in Satellite Beach, FL by specialty
• Clinical Child & Adolescent Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.