| Carmen Cornide, Psy.d., P.a. | |
|
1601 N Palm Ave Suite 300 Pembroke Pines FL 33026-3200 | |
| (954) 443-0018 | |
| (954) 236-6331 |
| Full Name | Carmen Cornide, Psy.d., P.a. |
|---|---|
| Speciality | Psychologist |
| Location | 1601 N Palm Ave, Pembroke Pines, Florida |
| Authorized Official Name and Position | Carmen Cornide (PRESIDENT) |
| Authorized Official Contact | 9544430018 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carmen Cornide, Psy.d., P.a. 1601 N Palm Ave Suite 300 Pembroke Pines FL 33026-3200 Ph: (954) 443-0018 | Carmen Cornide, Psy.d., P.a. 1601 N Palm Ave Suite 300 Pembroke Pines FL 33026-3200 Ph: (954) 443-0018 |
| NPI Number | 1952784225 |
|---|---|
| Provider Enumeration Date | 07/06/2015 |
| Last Update Date | 07/07/2015 |
| Medicare PECOS PAC ID | 3072813625 |
|---|---|
| Medicare Enrollment ID | O20151203001602 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952784225 | NPI | - | NPPES |
| 54131 | Other | FL | MEDICARE PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY5595 (Florida) | Primary |
| Provider Name | Carmen R Cornide |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699796011 PECOS PAC ID: 3476697244 Enrollment ID: I20100217000204 |
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