| Avellaneda Psychological Servivces Pa | |
|
270 North Bridge Street Labelle FL 33935 | |
| (305) 439-6014 | |
| Not Available |
| Full Name | Avellaneda Psychological Servivces Pa |
|---|---|
| Speciality | Psychologist |
| Location | 270 North Bridge Street, Labelle, Florida |
| Authorized Official Name and Position | Victoria Bustamante Avellaneda (PRESIDENT) |
| Authorized Official Contact | 3054396014 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Avellaneda Psychological Servivces Pa 2100 Riviera Ave Clewiston FL 33440-9043 Ph: (305) 439-6014 | Avellaneda Psychological Servivces Pa 270 North Bridge Street Labelle FL 33935 Ph: (305) 439-6014 |
| NPI Number | 1215461124 |
|---|---|
| Provider Enumeration Date | 04/18/2017 |
| Last Update Date | 11/20/2017 |
| Medicare PECOS PAC ID | 3577822154 |
|---|---|
| Medicare Enrollment ID | O20180108001135 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215461124 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PY5919 (Florida) | Primary |
| Provider Name | Victoria B Avellaneda |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740297266 PECOS PAC ID: 5698813277 Enrollment ID: I20091119000326 |
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