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General NPI Number Information
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NPI Number | 1376081679
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Entity Type | Organization
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Legal Business Name | SOUTH FLORIDA PSYCHOLOGICAL & FORENSIC ASSOCIATES LLC
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Dates
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Enumeration Date | 02/07/2017
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Last Update Date | 02/07/2017
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Provider Practice Location Address
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Address Line | 1801 NE 123RD ST STE 314
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City | NORTH MIAMI
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State | FL
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Zip | 33181-2883
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Country | US
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Telephone | 305-905-5240
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Fax |
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Provider Business Mailing Address
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Address Line | 1801 NE 123RD ST STE 314
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City | NORTH MIAMI
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State | FL
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Zip | 33181-2883
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF PSYCHOLOGIST
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Name | DR. ALINA PEREZ
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Credential | PH.D.
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Telephone | 305-905-5240
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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 | PY9778
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License Number State | FL
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