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General NPI Number Information
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NPI Number | 1588017123
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Entity Type | Organization
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Legal Business Name | ELAINE KARBONIK PSYD PA
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Dates
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Enumeration Date | 07/19/2016
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Last Update Date | 07/19/2016
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Provider Practice Location Address
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Address Line | 5337 ORANGE DR
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City | DAVIE
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State | FL
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Zip | 33314-3815
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Country | US
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Telephone | 954-562-3640
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Fax |
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Provider Business Mailing Address
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Address Line | 10500 NW 5TH MNR
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City | PLANTATION
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State | FL
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Zip | 33324-1647
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Country | US
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Telephone | 954-562-3640
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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. ELAINE KARBONIK
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Credential | PSYD
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Telephone | 954-562-3640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | PY 6992
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License Number State | FL
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