| Aliza Rosen, Psy.d.,p.a. | |
|
1370 Bedford Dr 106 Melbourne FL 32940-1993 | |
| (321) 757-7957 | |
| (321) 265-4015 |
| Full Name | Aliza Rosen, Psy.d.,p.a. |
|---|---|
| Speciality | Psychologist |
| Location | 1370 Bedford Dr, Melbourne, Florida |
| Authorized Official Name and Position | Aliza N Rosen (PRESIDENT) |
| Authorized Official Contact | 3217577957 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aliza Rosen, Psy.d.,p.a. 1370 Bedford Dr Ste 102 Melbourne FL 32940-1993 Ph: (321) 757-7957 | Aliza Rosen, Psy.d.,p.a. 1370 Bedford Dr 106 Melbourne FL 32940-1993 Ph: (321) 757-7957 |
| NPI Number | 1134213903 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 02/20/2020 |
| Certification Date | 02/20/2020 |
| Medicare PECOS PAC ID | 7113976432 |
|---|---|
| Medicare Enrollment ID | O20050113000581 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134213903 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY6029 (Florida) | Primary |
| Provider Name | Aliza N Rosen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700970662 PECOS PAC ID: 3476502790 Enrollment ID: I20050114000202 |
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