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General NPI Number Information
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NPI Number | 1114379930
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Entity Type | Organization
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Legal Business Name | LISA D ROLLINS-GARCIA, PH.D., P.A.
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Dates
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Enumeration Date | 07/05/2016
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Last Update Date | 07/05/2016
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Provider Practice Location Address
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Address Line | 12300 ALTERNATE A1A STE 108
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-2205
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Country | US
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Telephone | 561-625-9464
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Fax |
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Provider Business Mailing Address
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Address Line | 11954 BANYAN ST
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-2106
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Country | US
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Telephone | 561-308-5035
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LISA D ROLLINS-GARCIA
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Credential | PH.D.
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Telephone | 561-308-5035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY5334
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License Number State | FL
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