| Drlullaby Llc | |
|
3479 Ne 163rd St Ste 1208 North Miami Beach FL 33160-4426 | |
| (844) 475-3379 | |
| (855) 644-2986 |
| Full Name | Drlullaby Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3479 Ne 163rd St Ste 1208, North Miami Beach, Florida |
| Authorized Official Name and Position | Lisa Ann Medalie (CEO) |
| Authorized Official Contact | 6199975759 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Drlullaby Llc 1440 W Taylor St # 556 Chicago IL 60607-4623 Ph: (844) 475-3379 | Drlullaby Llc 3479 Ne 163rd St Ste 1208 North Miami Beach FL 33160-4426 Ph: (844) 475-3379 |
| NPI Number | 1790499838 |
|---|---|
| Provider Enumeration Date | 01/12/2023 |
| Last Update Date | 03/27/2023 |
| Certification Date | 03/27/2023 |
| Medicare PECOS PAC ID | 9931507290 |
|---|---|
| Medicare Enrollment ID | O20230224002056 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790499838 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TB0200X | Psychologist - Cognitive & Behavioral | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Jayme Hodges |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174939144 PECOS PAC ID: 7416174552 Enrollment ID: I20140813000744 |
| Provider Name | Mary Elizabeth Cannon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831747369 PECOS PAC ID: 2860813607 Enrollment ID: I20200602002222 |
| Provider Name | Sarah Zwetzig |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851032064 PECOS PAC ID: 8820477979 Enrollment ID: I20230227003001 |
| Provider Name | Guylene Velez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730216672 PECOS PAC ID: 0143308593 Enrollment ID: I20230309000168 |
| Provider Name | Lisa Medalie |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609175744 PECOS PAC ID: 7315122520 Enrollment ID: I20230426002809 |
| Provider Name | Fanie Pierre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427536093 PECOS PAC ID: 4789046475 Enrollment ID: I20230811002049 |
| Provider Name | Chelsea Pryor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467157453 PECOS PAC ID: 4183078413 Enrollment ID: I20230920003086 |
| Provider Name | Sheryl Leytham |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1891887162 PECOS PAC ID: 1658343280 Enrollment ID: I20230929000019 |
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