=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578750634
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PATRICIA FRELL PSYD. P.A.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/02/2007
-----------------------------------------------------
Last Update Date | 03/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9660 W SAMPLE RD STE 301
-----------------------------------------------------
City | CORAL SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33065-4052
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-757-7564
-----------------------------------------------------
Fax | 954-340-3674
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9822 NW 13TH CT
-----------------------------------------------------
City | CORAL SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33071-5923
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-757-7564
-----------------------------------------------------
Fax | 954-340-3674
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MRS. PATRICIA ANN FRELL
-----------------------------------------------------
Credential | DR.
-----------------------------------------------------
Telephone | 954-757-7564
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------