Michael J. Ditomasso Ph.d., P.a. | |
13834 Sw 122nd Ct Miami FL 33186-6052 | |
(305) 256-4324 | |
(305) 256-5610 |
Full Name | Michael J. Ditomasso Ph.d., P.a. |
---|---|
Speciality | Psychologist - Clinical |
Location | 13834 Sw 122nd Ct, Miami, Florida |
Authorized Official Name and Position | Michael John Ditomasso (OWNER) |
Authorized Official Contact | 3052565610 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Michael J. Ditomasso Ph.d., P.a. 13834 Sw 122nd Ct Miami FL 33186-6052 Ph: (305) 256-4324 | Michael J. Ditomasso Ph.d., P.a. 13834 Sw 122nd Ct Miami FL 33186-6052 Ph: (305) 256-4324 |
NPI Number | 1447452081 |
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Provider Enumeration Date | 06/05/2007 |
Last Update Date | 11/30/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447452081 | NPI | - | NPPES |
7672951 | Medicaid | FL | |
59897 | Other | FL | BLUE CROSS PROVIDER NUMBE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | PY 5449 (Florida) | Primary |
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