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General NPI Number Information
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NPI Number | 1215042502
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Entity Type | Individual
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Provider Name | ROBERT D ASSAEL PHD
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Gender | Male
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 10/20/2012
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Provider Practice Location Address
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Address Line | 6750 N ANDREWS AVE SUITE 200 - CYPRESS PARK WEST
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309-2173
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Country | US
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Telephone | 954-979-8501
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Fax | 954-979-8502
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Provider Business Mailing Address
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Address Line | 1132 W CYPRESS DR V-17
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City | POMPANO BEACH
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State | FL
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Zip | 33069-4107
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Country | US
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Telephone | 954-979-8501
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Fax | 954-979-8502
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | PY0004585
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License Number State | FL
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