Dr Lourdes Portales Dale, PHD in Jacksonville, FL - Medicare Psychologist Provider

Dr Lourdes Portales Dale, PHD is a medicare enrolled "Psychologist - Clinical Child & Adolescent" provider in Jacksonville, Florida. Her current practice location is 580 W 8th St Fl Towerii6, Jacksonville, Florida. You can reach out to her office (for appointments etc.) via phone at (860) 305-2908.

Dr Lourdes Portales Dale is licensed to practice in Florida (license number 10538) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1952927600.

Contact Information

	Dr Lourdes Portales Dale, PHD
	580 W 8th St Fl Towerii6, Jacksonville, FL 32209-6533
	(860) 305-2908
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Lourdes Portales Dale
Gender	Female
Speciality	Psychologist - Clinical Child & Adolescent
Location	580 W 8th St Fl Towerii6, Jacksonville, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1952927600
Provider Enumeration Date: 06/18/2020
Last Update Date: 06/18/2020

Medicare PECOS Information:

PECOS PAC ID: 2567887763
Enrollment ID: I20200805001521

Medical Identifiers

Medical identifiers for Dr Lourdes Portales Dale such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1952927600	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103T00000X	Psychologist	002436 (Connecticut)	Secondary
103TC2200X	Psychologist - Clinical Child & Adolescent	10538 (Florida)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Lourdes Portales Dale allows following entities to bill medicare on her behalf.

Entity Name	University Of Florida Jacksonville Physicians, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1144276452 PECOS PAC ID: 9133025869 Enrollment ID: O20051221000986

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Lourdes Portales Dale is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Lourdes Portales Dale, PHD 830-13 A1a North, #690, Ponte Vedra Beach, FL 32082 Ph: (860) 305-2908	Dr Lourdes Portales Dale, PHD 580 W 8th St Fl Towerii6, Jacksonville, FL 32209-6533 Ph: (860) 305-2908

Reviews and Comments

Psychologist in Jacksonville, FL

Dr. Purnima Kumar, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 5251 Emerson St, Jacksonville, FL 32207 Phone: 904-399-0324 Fax: 904-399-0420
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Rachel Suzanne Wasson, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000
Dr. Tanis Jill Ferman, PH.D Psychologist Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000

Dr Lourdes Portales Dale, PHD - Medicare Psychologist in Jacksonville, FL