Healthcare Provider Details

I. General information

NPI: 1386036945
Provider Name (Legal Business Name): AUTISM PSYCHIATRY, INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2015
Last Update Date: 02/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9700 S DIXIE HWY SUITE 930
MIAMI FL
33156-2800
US

IV. Provider business mailing address

9700 S DIXIE HWY SUITE 930
MIAMI FL
33156-2800
US

V. Phone/Fax

Practice location:
  • Phone: 305-409-7763
  • Fax: 888-971-4403
Mailing address:
  • Phone: 305-409-7763
  • Fax: 888-971-4403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME 121778
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberME 121778
License Number StateFL

VIII. Authorized Official

Name: DR. RODNEY ELDEN PARKER-YARNAL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 305-409-7763