Healthcare Provider Details

I. General information

NPI: 1871526491
Provider Name (Legal Business Name): JUDITH MIGOYA PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 07/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12514 W ATLANTIC BLVD
CORAL SPRINGS FL
33071-4085
US

IV. Provider business mailing address

12514 W ATLANTIC BLVD
CORAL SPRINGS FL
33071-4085
US

V. Phone/Fax

Practice location:
  • Phone: 954-464-0583
  • Fax: 954-697-0275
Mailing address:
  • Phone: 954-464-0583
  • Fax: 954-697-0275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPY6769
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: