Healthcare Provider Details

I. General information

NPI: 1265512925
Provider Name (Legal Business Name): PINES PSYCHOLOGICAL ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 12/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 N HIATUS RD SUITE 213
PEMBROKE PINES FL
33026-5206
US

IV. Provider business mailing address

700 N HIATUS RD 213
PEMBROKE PINES FL
33026-5206
US

V. Phone/Fax

Practice location:
  • Phone: 954-431-0411
  • Fax: 954-431-0413
Mailing address:
  • Phone: 954-431-0411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. KAREN SCOTT
Title or Position: OWNER
Credential: PSY.D.
Phone: 954-431-0411