Healthcare Provider Details

I. General information

NPI: 1396351979
Provider Name (Legal Business Name): DANIELA OLIVEIRA DE MEDEIROS PSY.D, MS.ED, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DR. DANIELA OLIVEIRA DE MEDEIROS

II. Dates (important events)

Enumeration Date: 09/19/2020
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3232 CORAL WAY APT 1406
MIAMI FL
33145-3189
US

IV. Provider business mailing address

3232 CORAL WAY APT 1406
MIAMI FL
33145-3189
US

V. Phone/Fax

Practice location:
  • Phone: 305-403-9336
  • Fax: 786-936-5616
Mailing address:
  • Phone: 305-403-9336
  • Fax: 786-936-5616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY10790
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: