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DAVID M BORTNICK PHD PSY D PA
NPI 1225560949
Clinical Neuropsychologist in St Augustine, FL

Active since March 31, 2017
1750 TREE BLVD STE 5, ST AUGUSTINE, FL 32084(904) 342-0672(904) 342-0673 Get Directions Write a Review

NPPES record last updated: January 6, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 6, 2020, Mar 31, 2017 (2 updates tracked since 2017).

About David M Bortnick Phd Psy D Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DAVID M BORTNICK PHD PSY D PA (NPI 1225560949) is a healthcare organization registered as a clinical neuropsychologist in St Augustine, Florida and active in the NPI registry since March 2017. The organization lists David M Bortnick, Owner President, as its authorized official.

NPPES Registry Identity

NPI1225560949
Entity TypeOrganization
Primary Taxonomy103G00000X
Legal Business NameDAVID M BORTNICK PHD PSY D PA
Location Address1750 TREE BLVD STE 5St Augustine, FL 32084-5719
Mailing AddressPo Box 3123St Augustine, FL 32085-3123
Phone(904) 342-0672
Fax(904) 342-0673
Organization SubpartNo
Authorized OfficialDavid M BortnickOwner President · (904) 392-1687
Enumeration DateMarch 31, 2017
Last NPPES UpdateJanuary 6, 20202 updates tracked since enumeration
✔ NPI 1225560949 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers
Taxonomy Code103G00000X
License✔ Licensed in FL · PY2065
Definition
A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.
1750 TREE BLVD STE 5, St Augustine, FL 32084
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DAVID M BORTNICK PHD PSYD ABN
Clinical Neuropsychologist
1750 TREE BLVD STE 5
ST AUGUSTINE, FL 32084
St. Johns County (904) 342-0672
ANGELIA FULLER ARNP
Nurse Practitioner (Family)
1750 TREE BLVD STE 5
ST AUGUSTINE, FL 32084
St. Johns County (904) 342-0672

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is David M Bortnick Phd Psy D PA's NPI number?

The NPI number for David M Bortnick Phd Psy D PA is 1225560949. It was assigned to this organization in the NPPES registry on March 31, 2017.

Where is David M Bortnick Phd Psy D PA located?

David M Bortnick Phd Psy D PA is located at 1750 Tree Blvd Ste 5, St Augustine, FL 32084. The listed phone number is (904) 342-0672.

What is David M Bortnick Phd Psy D PA's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

When was this NPI record last updated?

The NPPES record for David M Bortnick Phd Psy D PA was last updated on January 6, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.