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NPI Code Detail

MEDICARE: DR. CAROL WARTENBERG PH.D.

MEDICARE: DR. CAROL WARTENBERG PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistPY4103FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730175514
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CAROL WARTENBERG PH.D.
Provider Business Mailing Address
First Line : 4300 N UNIVERSITY
Second Line : C100
City : LAUDERHILL
State : FL
Zip : 33351-1050
Country : US
Telephone Number : 954-742-7449
Fax Number : 954-742-7169
Provider Business Practice Location Address
First Line : 901 S 62ND AVE
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33023-1848
Country : US
Telephone Number : 561-790-1191
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2005
Last Update Date : 02/06/2020

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