| Palmwood Center For Psychological Services, P.a. | |
|
8890 W Oakland Park Blvd Suite #103 Sunrise FL 33351-7235 | |
| (954) 742-7032 | |
| (954) 742-7868 |
| Full Name | Palmwood Center For Psychological Services, P.a. |
|---|---|
| Speciality | Psychologist |
| Location | 8890 W Oakland Park Blvd, Sunrise, Florida |
| Authorized Official Name and Position | Alec Roth (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 9547427032 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Palmwood Center For Psychological Services, P.a. 8890 W Oakland Park Blvd Suite #103 Sunrise FL 33351-7235 Ph: (954) 742-7032 | Palmwood Center For Psychological Services, P.a. 8890 W Oakland Park Blvd Suite #103 Sunrise FL 33351-7235 Ph: (954) 742-7032 |
| NPI Number | 1306055942 |
|---|---|
| Provider Enumeration Date | 05/21/2007 |
| Last Update Date | 04/27/2011 |
| Medicare PECOS PAC ID | 5092993527 |
|---|---|
| Medicare Enrollment ID | O20110701000092 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306055942 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY0004153 (Florida) | Primary |
| Provider Name | Marlene Gray |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780670539 PECOS PAC ID: 1456538537 Enrollment ID: I20110527000535 |
| Provider Name | Jonathan D Pearlson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1154703619 PECOS PAC ID: 1456652742 Enrollment ID: I20161213001459 |
| Provider Name | Leslie Michelle Diaz-ortiz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235781873 PECOS PAC ID: 3476880626 Enrollment ID: I20190809001932 |
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