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1175 N.e. 125 St. #201 No. Miami FL 33161-2218 | |
(305) 891-4821 | |
(305) 891-4271 |
Full Name | |
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Speciality | Psychologist - Clinical |
Location | 1175 N.e. 125 St., No. Miami, Florida |
Authorized Official Name and Position | Richard S Greenbaum (PRESIDENT) |
Authorized Official Contact | 3058914821 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1175 N.e. 125 St. #201 No. Miami FL 33161-2218 Ph: (305) 891-4821 | 1175 N.e. 125 St. #201 No. Miami FL 33161-2218 Ph: (305) 891-4821 |
NPI Number | 1184950933 |
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Provider Enumeration Date | 10/29/2009 |
Last Update Date | 10/29/2009 |
Identifier | Type | State | Issuer |
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1184950933 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103TC0700X | Psychologist - Clinical | PY2247 (Florida) | Primary |