| Broward Psychology Center | |
|
7420 Nw 5th St Ste 103 Plantation FL 33317-1611 | |
| (954) 817-6372 | |
| Not Available |
| Full Name | Broward Psychology Center |
|---|---|
| Speciality | Psychologist |
| Location | 7420 Nw 5th St Ste 103, Plantation, Florida |
| Authorized Official Name and Position | Charu Jain (PRESIDENT) |
| Authorized Official Contact | 9548176372 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Broward Psychology Center 7420 Nw 5th St Ste 103 Plantation FL 33317-1611 Ph: (954) 817-6372 | Broward Psychology Center 7420 Nw 5th St Ste 103 Plantation FL 33317-1611 Ph: (954) 817-6372 |
| NPI Number | 1962896191 |
|---|---|
| Provider Enumeration Date | 03/25/2015 |
| Last Update Date | 09/29/2020 |
| Certification Date | 09/29/2020 |
| Medicare PECOS PAC ID | 0840571444 |
|---|---|
| Medicare Enrollment ID | O20161219001902 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962896191 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY9137 (Florida) | Primary |
| Provider Name | Charu Jain |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265834337 PECOS PAC ID: 9133442312 Enrollment ID: I20141218001956 |
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