Jameson Beach

Individual provider Active NPI Clinical Neuropsychologist · Pensacola, FL

NPI 1952015257 · NPPES record last updated Aug 12, 2024

Key facts

NPI
1952015257
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Neuropsychologist 103G00000X
License
11792 (FL)
Practice address
790 Veterans Way
Pensacola, FL 32507-1000
Phone
(850) 912-2000
NPI assigned
Jan 11, 2023
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
11792FLMDClinical Neuropsychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 11792 FL Yes

Addresses

Primary practice location

790 Veterans Way
Pensacola, FL 32507-1000

Mailing address

7400 Merton Minter St
San Antonio, TX 78229-4404

Other providers in Pensacola, FL

All providers in Pensacola, FL · Clinical Neuropsychologist in Florida

Sources for this page

Verify at the official NPI Registry.