Active NPI
Estefany Sabrina Bologna Nino, PHD
- Psychologist
- Tampa, FL
National Provider Identifier
1841803160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY10855
- Practice address
- 13515 Lake Terrace LN
Tampa, FL 33637-1003 - Phone
- (813) 505-6972
- NPI assigned
- Aug 26, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY10855 | FL | |
| Psychologist | 103T00000X | PY10855 | FL | Primary |
Addresses
Primary practice location
13515 Lake Terrace LN
Tampa, FL 33637-1003
Mailing address
13515 Lake Terrace LN
Tampa, FL 33637-1003
Phone (813) 505-6972
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 |
|---|---|---|---|
| PY10855 | FL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598400000000",
"number": "1841803160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13515 LAKE TERRACE LN",
"city": "TAMPA",
"state": "FL",
"postal_code": "336371003",
"telephone_number": "813-505-6972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13515 LAKE TERRACE LN",
"city": "TAMPA",
"state": "FL",
"postal_code": "336371003",
"telephone_number": "813-505-6972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLOGNA NINO",
"first_name": "ESTEFANY",
"middle_name": "SABRINA",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-26",
"last_updated": "2020-08-26",
"certification_date": "2020-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY10855",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "FL",
"license": "PY10855",
"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 Aug 26, 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.