Healthcare Provider Details

I. General information

NPI: 1376469270
Provider Name (Legal Business Name): PSYC CONSULTATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9370 SW 72ND ST STE A213
MIAMI FL
33173-5452
US

IV. Provider business mailing address

9370 SW 72ND ST STE A213
MIAMI FL
33173-5452
US

V. Phone/Fax

Practice location:
  • Phone: 305-712-4580
  • Fax:
Mailing address:
  • Phone: 305-712-4580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. ISRAEL A SARASTI
Title or Position: OWNER
Credential: PHD
Phone: 305-712-4580