| Peysaf Worthalter, M.d., P.a. | |
|
20824 W Dixie Hwy Miami FL 33180-1147 | |
| (305) 654-0907 | |
| (305) 999-0011 |
| Full Name | Peysaf Worthalter, M.d., P.a. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 20824 W Dixie Hwy, Miami, Florida |
| Authorized Official Name and Position | Peysaf Worthalter (PRESIDENT) |
| Authorized Official Contact | 3056540907 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peysaf Worthalter, M.d., P.a. 20824 W Dixie Hwy Miami FL 33180-1147 Ph: (305) 654-0907 | Peysaf Worthalter, M.d., P.a. 20824 W Dixie Hwy Miami FL 33180-1147 Ph: (305) 654-0907 |
| NPI Number | 1104032739 |
|---|---|
| Provider Enumeration Date | 05/14/2007 |
| Last Update Date | 09/10/2007 |
| Medicare PECOS PAC ID | 1951299817 |
|---|---|
| Medicare Enrollment ID | O20040310000986 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104032739 | NPI | - | NPPES |
| 96159 | Other | FL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Peysaf Wolf Worthalter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265627608 PECOS PAC ID: 1951299825 Enrollment ID: I20110627000190 |
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