Active NPI
Denise P Federer, PH.D.
- Psychologist
- Tampa, FL
National Provider Identifier
1720114762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY3573
- Practice address
- 3641 W Kennedy Blvd
Suite G
Tampa, FL 33609-2851 - Phone
- (813) 876-7191
- Fax
- (813) 876-9008
- NPI assigned
- Feb 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY3573 | FL | Primary |
Addresses
Primary practice location
3641 W Kennedy Blvd
Suite G
Tampa, FL 33609-2851
Mailing address
3641 W Kennedy Blvd
Suite G
Tampa, FL 33609-2851
Phone (813) 876-7191
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 |
|---|---|---|---|
| PY3573 | FL | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720114762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3641 W KENNEDY BLVD",
"address_2": "SUITE G",
"city": "TAMPA",
"state": "FL",
"postal_code": "336092851",
"telephone_number": "813-876-7191",
"fax_number": "813-876-9008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3641 W KENNEDY BLVD",
"address_2": "SUITE G",
"city": "TAMPA",
"state": "FL",
"postal_code": "336092851",
"telephone_number": "813-876-7191",
"fax_number": "813-876-9008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEDERER",
"first_name": "DENISE",
"middle_name": "P",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "FL",
"license": "PY3573",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.