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3100 Sw 62nd Ave Department Of Psychology Miami FL 33155-3009 | |
| (786) 624-5876 | |
| (786) 624-2688 |
| Full Name | |
|---|---|
| Speciality | Psychologist - Clinical Child & Adolescent |
| Location | 3100 Sw 62nd Ave, Miami, Florida |
| Authorized Official Name and Position | Marcos Mestre (SVP) |
| Authorized Official Contact | 3056666511 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 947095 Atlanta GA 30394-7095 Ph: (786) 624-5876 | 3100 Sw 62nd Ave Department Of Psychology Miami FL 33155-3009 Ph: (786) 624-5876 |
| NPI Number | 1194277756 |
|---|---|
| Provider Enumeration Date | 10/31/2016 |
| Last Update Date | 11/12/2024 |
| Certification Date | 11/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194277756 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | (* (Not Available)) | Primary |
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