Healthcare Provider Details

I. General information

NPI: 1285882050
Provider Name (Legal Business Name): LISA FARALDO PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2008
Last Update Date: 04/12/2026
Certification Date: 04/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2295 NW CORPORATE BLVD STE 231
BOCA RATON FL
33431-7323
US

IV. Provider business mailing address

2295 NW CORPORATE BLVD STE 231
BOCA RATON FL
33431-7323
US

V. Phone/Fax

Practice location:
  • Phone: 954-812-0900
  • Fax:
Mailing address:
  • Phone: 954-812-0900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY7777
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: