| Maria V. Nodarse, Psy. D., Inc | |
|
1175 Lucerne Dr Mount Dora FL 32757-3639 | |
| (352) 630-0373 | |
| (352) 385-0128 |
| Full Name | Maria V. Nodarse, Psy. D., Inc |
|---|---|
| Speciality | Psychologist |
| Location | 1175 Lucerne Dr, Mount Dora, Florida |
| Authorized Official Name and Position | Maria V Nodarse (LICENSED CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 3526300373 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maria V. Nodarse, Psy. D., Inc 3279 Lakeshore Dr Mount Dora FL 32757-5410 Ph: (352) 321-0098 | Maria V. Nodarse, Psy. D., Inc 1175 Lucerne Dr Mount Dora FL 32757-3639 Ph: (352) 630-0373 |
| NPI Number | 1609405729 |
|---|---|
| Provider Enumeration Date | 04/02/2020 |
| Last Update Date | 04/02/2020 |
| Certification Date | 04/02/2020 |
| Medicare PECOS PAC ID | 2961832563 |
|---|---|
| Medicare Enrollment ID | O20200422003040 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609405729 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Maria V Nodarse |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376811893 PECOS PAC ID: 2961787007 Enrollment ID: I20191209000509 |
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