Gulfside Psychology Inc

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Legal business name

GULFSIDE PSYCHOLOGY INC

Practice address

3902 E State Road 64
Bradenton, FL 34208-9059

Phone

(941) 243-3005

Fax

(941) 739-9358

NPI assigned

Mar 3, 2020

Organization subpart

No

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

Authorized official

Name

Mr. John K McDermott, OWNER

Title

President

Phone

(941) 243-3005

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1583193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596585600000",
    "number": "1861026569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5614 CLOVERLEAF RUN",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342114048",
            "telephone_number": "860-250-4488",
            "fax_number": "941-739-9358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3902 E STATE ROAD 64",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342089059",
            "telephone_number": "941-243-3005",
            "fax_number": "941-739-9358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULFSIDE PSYCHOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-03",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A",
        "authorized_official_last_name": "MCDERMOTT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "941-243-3005",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gulf Coast Music Therapy, Inc.
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• Gulfcoast Urology
• Gulfside Behavioral Care NP Inc
• Jennifer Gunn, MS, OTR/L
• Amit Kumar Gupta, MD
• Vivek Gupta, MD
• Michael J Gurucharri, M.D.
• Antonieta Gutierrez, MD

• Clinical Neuropsychologist in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Clinical Neuropsychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.

Verify at the official NPI Registry.