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2866 E Oakland Park Blvd Ste 3 Fort Lauderdale FL 33306-1819 | |
| (954) 767-6320 | |
| (954) 767-6425 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 2866 E Oakland Park Blvd Ste 3, Fort Lauderdale, Florida |
| Authorized Official Name and Position | Alisa Bert (INTERIM CFO) |
| Authorized Official Contact | 9548474117 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1700 Nw 49th St Ste 125 Fort Lauderdale FL 33309-3750 Ph: (954) 767-5320 | 2866 E Oakland Park Blvd Ste 3 Fort Lauderdale FL 33306-1819 Ph: (954) 767-6320 |
| NPI Number | 1255982575 |
|---|---|
| Provider Enumeration Date | 09/27/2019 |
| Last Update Date | 10/16/2024 |
| Certification Date | 10/16/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255982575 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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