Healthcare Provider Details

I. General information

NPI: 1790978435
Provider Name (Legal Business Name): ROSLYN PASS PHD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2007
Last Update Date: 11/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9085 SW 87TH AVE SUITE 201
MIAMI FL
33176-2309
US

IV. Provider business mailing address

9085 SW 87TH AVE SUITE 201
MIAMI FL
33176-2309
US

V. Phone/Fax

Practice location:
  • Phone: 305-595-2077
  • Fax:
Mailing address:
  • Phone: 305-595-2077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. ROSLYN PASS
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 305-595-2600