| Bird Of Paradise Psychological Services Pa | |
|
7051 W. Commercial Blvd Suite #3a Tamarac FL 33319-2146 | |
| (954) 720-0412 | |
| (954) 720-0824 |
| Full Name | Bird Of Paradise Psychological Services Pa |
|---|---|
| Speciality | Psychologist |
| Location | 7051 W. Commercial Blvd, Tamarac, Florida |
| Authorized Official Name and Position | Karlin Antoinette Donegal (OWNER, CEO, CFO) |
| Authorized Official Contact | 9547200412 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bird Of Paradise Psychological Services Pa 7051 W. Commercial Blvd Suite #3a Tamarac FL 33319-2146 Ph: (954) 720-0412 | Bird Of Paradise Psychological Services Pa 7051 W. Commercial Blvd Suite #3a Tamarac FL 33319-2146 Ph: (954) 720-0412 |
| NPI Number | 1184886624 |
|---|---|
| Provider Enumeration Date | 06/26/2008 |
| Last Update Date | 10/02/2014 |
| Medicare PECOS PAC ID | 5496811572 |
|---|---|
| Medicare Enrollment ID | O20090226000228 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184886624 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY6151 (Florida) | Primary |
| Provider Name | Karlin A Donegal |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1770670549 PECOS PAC ID: 8224194303 Enrollment ID: I20090226000220 |
| Provider Name | Miriam J Rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619398419 PECOS PAC ID: 2567897101 Enrollment ID: I20200108002911 |
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