Active NPI
Ralph J Dolente, PSY.D.
- Clinical Neuropsychologist
- Bartow, FL
National Provider Identifier
1982816856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- PY4209
- Practice address
- 150 N Central Ave
Bartow, FL 33830-4742 - Phone
- (863) 534-3017
- Fax
- (863) 534-8008
- NPI assigned
- May 4, 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 |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | PY4209 | FL | Primary |
Addresses
Primary practice location
150 N Central Ave
Bartow, FL 33830-4742
Mailing address
2301 Gatewood St
Plant City, FL 33563-8832
Phone (863) 534-3017
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY4209 | FL | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1982816856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2301 GATEWOOD ST",
"city": "PLANT CITY",
"state": "FL",
"postal_code": "335638832",
"telephone_number": "863-534-3017",
"fax_number": "863-534-8008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 N CENTRAL AVE",
"city": "BARTOW",
"state": "FL",
"postal_code": "338304742",
"telephone_number": "863-534-3017",
"fax_number": "863-534-8008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOLENTE",
"first_name": "RALPH",
"middle_name": "J",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "FL",
"license": "PY4209",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bartow, 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.