| Cheryl N Coletta Psy D Pa | |
|
5301 N Federal Hwy Ste 380 Boca Raton FL 33487-4916 | |
| (561) 279-5599 | |
| Not Available |
| Full Name | Cheryl N Coletta Psy D Pa |
|---|---|
| Speciality | Psychologist |
| Location | 5301 N Federal Hwy Ste 380, Boca Raton, Florida |
| Authorized Official Name and Position | Cheryl Nancy Coletta (OWNER/PRESIDENT) |
| Authorized Official Contact | 5612795599 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cheryl N Coletta Psy D Pa 5301 N Federal Hwy Ste 380 Boca Raton FL 33487-4916 Ph: (561) 279-5599 | Cheryl N Coletta Psy D Pa 5301 N Federal Hwy Ste 380 Boca Raton FL 33487-4916 Ph: (561) 279-5599 |
| NPI Number | 1629401351 |
|---|---|
| Provider Enumeration Date | 08/16/2013 |
| Last Update Date | 12/15/2023 |
| Certification Date | 12/15/2023 |
| Medicare PECOS PAC ID | 2769612472 |
|---|---|
| Medicare Enrollment ID | O20140225001490 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629401351 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PY 8588 (Florida) | Primary |
| Provider Name | Cheryl Nancy Coletta |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356774061 PECOS PAC ID: 3678703386 Enrollment ID: I20200622001047 |
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