Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PY8524 | FL |
Y | 103T00000X | Psychologist | PY8524 | FL |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PY 8524 | FL |
NPI | 1063644805 |
---|---|
Provider Name | Dr. Scott David Bakay |
First Address | Tampa, FL 33647-2873 |
Second Address | Tampa, FL 33647-2873 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2009 |
Last Update Date | 19/04/2019 |