Healthcare Provider Details
I. General information
NPI: 1598161424
Provider Name (Legal Business Name): MARIA DEL PILAR FERNANDEZ, PSY.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/04/2014
Last Update Date: 11/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8525 SW 92ND ST STE B8
MIAMI FL
33156-7374
US
IV. Provider business mailing address
8525 SW 92ND ST STE B8
MIAMI FL
33156-7374
US
V. Phone/Fax
- Phone: 305-596-9989
- Fax: 305-598-0220
- Phone: 305-596-9989
- Fax: 305-598-0220
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | PY 8627 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | PY 8627 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TH0004X |
| Taxonomy | Health Psychologist |
| License Number | PY 8627 |
| License Number State | FL |
VIII. Authorized Official
Name: DR.
MARIA
DEL PILAR
FERNANDEZ
Title or Position: DOCTOR/CLINICAL PSYCHOLOGIST
Credential: PSY.D.
Phone: 305-596-9989