| Hammerhead Psychological Services, Llc | |
|
9160 Forum Corporate Pkwy Ste 350 Fort Myers FL 33905-7808 | |
| (239) 391-7313 | |
| Not Available |
| Full Name | Hammerhead Psychological Services, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 9160 Forum Corporate Pkwy Ste 350, Fort Myers, Florida |
| Authorized Official Name and Position | Kenneth Christopher Lazzara (SOLE MEMBER) |
| Authorized Official Contact | 2393917313 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hammerhead Psychological Services, Llc 9160 Forum Corporate Pkwy Ste 350 Fort Myers FL 33905-7808 Ph: (239) 391-7313 | Hammerhead Psychological Services, Llc 9160 Forum Corporate Pkwy Ste 350 Fort Myers FL 33905-7808 Ph: (239) 391-7313 |
| NPI Number | 1417658543 |
|---|---|
| Provider Enumeration Date | 03/15/2023 |
| Last Update Date | 03/15/2023 |
| Certification Date | 03/15/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417658543 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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