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General NPI Number Information
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NPI Number | 1083146153
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Entity Type | Organization
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Legal Business Name | THE PLAYFUL MINDS PSYCHOLOGY CENTER OF SOUTH FLORI
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Dates
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Enumeration Date | 03/29/2017
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Last Update Date | 03/29/2017
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Provider Practice Location Address
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Address Line | 2250 NW 136 AVE SUITE 100C
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-2586
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Country | US
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Telephone | 954-342-6130
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Fax |
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Provider Business Mailing Address
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Address Line | 2250 NW 136 AVE SUITE 100C
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-2586
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Country | US
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Telephone | 954-342-6130
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTIOR/OWNER
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Name | DR. MARIBEL DEL RIO-ROBERTS
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Credential | PSY.D.
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Telephone | 954-342-6130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY 7856
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License Number State | FL
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