| South Florida Neuropsychology | |
|
1601 Clint Moore Rd Suite 120 Boca Raton FL 33487-2768 | |
| (561) 732-7000 | |
| (561) 731-2997 |
| Full Name | South Florida Neuropsychology |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 1601 Clint Moore Rd, Boca Raton, Florida |
| Authorized Official Name and Position | Steven Michael Essig (PRESIDENT) |
| Authorized Official Contact | 5617327000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Florida Neuropsychology 107 Canterstone Ct Cary NC 27518-2251 Ph: (561) 732-7000 | South Florida Neuropsychology 1601 Clint Moore Rd Suite 120 Boca Raton FL 33487-2768 Ph: (561) 732-7000 |
| NPI Number | 1790936938 |
|---|---|
| Provider Enumeration Date | 10/07/2008 |
| Last Update Date | 05/10/2024 |
| Certification Date | 05/10/2024 |
| Medicare PECOS PAC ID | 9931176906 |
|---|---|
| Medicare Enrollment ID | O20040910000772 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790936938 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | PY6865 (Florida) | Primary |
| 103TC0700X | Psychologist - Clinical | PY6865 (Florida) | Secondary |
| Provider Name | Steven M Essig |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447322557 PECOS PAC ID: 7911974993 Enrollment ID: I20090220000333 |
| Provider Name | Raphael J Wald |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205145174 PECOS PAC ID: 9032390190 Enrollment ID: I20110311000597 |
| Provider Name | Rhonda Q Freeman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992821821 PECOS PAC ID: 9739337494 Enrollment ID: I20120921000285 |
| Provider Name | Diana Bronshteyn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174928881 PECOS PAC ID: 3779884077 Enrollment ID: I20151210000758 |
| Provider Name | Francy N Fonseca |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437517778 PECOS PAC ID: 4183920879 Enrollment ID: I20160307000601 |
| Provider Name | Jessica L Tylicki |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104550490 PECOS PAC ID: 6901288166 Enrollment ID: I20220804000416 |
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