| NPI | 1992239917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERONICA HERNANDEZ Billing Manager 954-203-3584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TC0700X Psychologist, Clinical | |
| 207RA0401X Internal Medicine, Addiction Medicine | |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2017-04-17 |