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General NPI Number Information
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NPI Number | 1447462346
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL MEDICINE SERVICES OF SOUTH FLORIDA
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3100 SW 62ND AVE STE 3-266
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City | MIAMI
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State | FL
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Zip | 33155-3009
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Country | US
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Telephone | 305-669-6503
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Fax |
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Provider Business Mailing Address
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Address Line | 3200 SW 60TH CT STE 302
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City | MIAMI
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State | FL
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Zip | 33155-4071
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Country | US
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Telephone | 305-669-6492
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | DR. MARISA AZARET
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Credential | PSY.D.
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Telephone | 305-669-6492
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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 |
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License Number State |
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