Healthcare Provider Details

I. General information

NPI: 1881647477
Provider Name (Legal Business Name): PAUL FERIA PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9360 SUNSET DR SUITE 234
MIAMI FL
33173-5432
US

IV. Provider business mailing address

9360 SUNSET DR SUITE 234
MIAMI FL
33173-5432
US

V. Phone/Fax

Practice location:
  • Phone: 305-274-8919
  • Fax: 305-274-4137
Mailing address:
  • Phone: 305-274-8919
  • Fax: 305-274-4137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY4380
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: