Healthcare Provider Details

I. General information

NPI: 1316683394
Provider Name (Legal Business Name): FLORIDA NEURO-HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2022
Last Update Date: 05/11/2022
Certification Date: 05/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19292 NE 8TH CT
MIAMI FL
33179-1370
US

IV. Provider business mailing address

19292 NE 8TH CT
MIAMI FL
33179-1370
US

V. Phone/Fax

Practice location:
  • Phone: 305-218-1790
  • Fax:
Mailing address:
  • Phone: 305-218-1790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. MARCELA KITAIGORODSKY
Title or Position: NEUROPSYCHOLOGIST
Credential: PSY.D.
Phone: 305-218-1790