Healthcare Provider Details

I. General information

NPI: 1619061595
Provider Name (Legal Business Name): DELWIN L PITZER PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 04/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 FOUNTAINEBLEAU CIR
DAYTONA BEACH FL
32118-4008
US

IV. Provider business mailing address

PO BOX 934068
MARGATE FL
33093-4068
US

V. Phone/Fax

Practice location:
  • Phone: 386-257-3892
  • Fax: 954-366-2056
Mailing address:
  • Phone: 954-366-2700
  • Fax: 954-366-2056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY5371
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY5371
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: