1952463168 NPI number — PSYCHOTHERAPY ASSOCIATES OF SOUTH FLORIDA, PA

Table of content: (NPI 1952463168)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952463168 NPI number — PSYCHOTHERAPY ASSOCIATES OF SOUTH FLORIDA, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PSYCHOTHERAPY ASSOCIATES OF SOUTH FLORIDA, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952463168
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5425 10TH FAIRWAY DR
Provider Second Line Business Mailing Address:
#3
Provider Business Mailing Address City Name:
DELRAY BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33484-7827
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-638-9391
Provider Business Mailing Address Fax Number:
561-431-2378

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
849 SE 8TH AVE
Provider Second Line Business Practice Location Address:
#2
Provider Business Practice Location Address City Name:
DEERFIELD BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33441-5615
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-929-2343
Provider Business Practice Location Address Fax Number:
561-431-2378
Provider Enumeration Date:
12/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KADIN
Authorized Official First Name:
CHRISTINE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRINCIPAL
Authorized Official Telephone Number:
561-638-9391

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  2004 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 101YM0800X , with the licence number: MH-5461 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com