| Mark Minson Phd, Pa | |
|
4710 Nw 2nd Ave Suite 104 Boca Raton FL 33431-4879 | |
| (561) 999-9890 | |
| (561) 999-9454 |
| Full Name | Mark Minson Phd, Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 4710 Nw 2nd Ave, Boca Raton, Florida |
| Authorized Official Name and Position | Mark I Minson (OWNER) |
| Authorized Official Contact | 5619999890 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark Minson Phd, Pa 4710 Nw 2nd Ave Suite 104 Boca Raton FL 33431-4879 Ph: (561) 999-9890 | Mark Minson Phd, Pa 4710 Nw 2nd Ave Suite 104 Boca Raton FL 33431-4879 Ph: (561) 999-9890 |
| NPI Number | 1760745459 |
|---|---|
| Provider Enumeration Date | 06/19/2012 |
| Last Update Date | 06/19/2012 |
| Medicare PECOS PAC ID | 5193952570 |
|---|---|
| Medicare Enrollment ID | O20131210000751 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760745459 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | PY3478 (Florida) | Primary |
| Provider Name | Mark Minson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518051069 PECOS PAC ID: 8628205069 Enrollment ID: I20131211000382 |
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