Healthcare Provider Details
I. General information
NPI: 1144588914
Provider Name (Legal Business Name): ADAM IGLESIAS PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/30/2012
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2401 PGA BLVD STE 230
PALM BEACH GARDENS FL
33410-3515
US
IV. Provider business mailing address
2401 PGA BLVD STE 230
PALM BEACH GARDENS FL
33410-3515
US
V. Phone/Fax
- Phone: 561-758-1704
- Fax:
- Phone: 561-758-1704
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | PY8522 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | PY8522 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: