Healthcare Provider Details

I. General information

NPI: 1659206555
Provider Name (Legal Business Name): DANIELA DE MEDEIROS, PSY.D., PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MAJORCA AVE
CORAL GABLES FL
33134-4508
US

IV. Provider business mailing address

111 MAJORCA AVE
CORAL GABLES FL
33134-4508
US

V. Phone/Fax

Practice location:
  • Phone: 305-403-9336
  • Fax: 305-448-0687
Mailing address:
  • Phone: 305-403-9336
  • Fax: 305-448-0687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIELA OLIVEIRA DE MEDEIROS
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PSY.D, MS.ED.
Phone: 305-403-9336