Healthcare Provider Details

I. General information

NPI: 1720276892
Provider Name (Legal Business Name): SHEILLA ST. FLEUROSE PSY.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHEILLA PIERRE-ANTOINE PSY.D

II. Dates (important events)

Enumeration Date: 10/13/2007
Last Update Date: 06/18/2020
Certification Date: 06/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1065 NE 125TH ST STE 206
NORTH MIAMI FL
33161-5832
US

IV. Provider business mailing address

1065 NE 125TH ST STE 409
NORTH MIAMI FL
33161-5834
US

V. Phone/Fax

Practice location:
  • Phone: 888-852-6672
  • Fax: 305-891-4228
Mailing address:
  • Phone: 888-852-6672
  • Fax: 305-891-4228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY7312
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPY7312
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: