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General NPI Number Information
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NPI Number | 1770724353
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Entity Type | Organization
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Legal Business Name | DOCDESDINPSYCHSERVICES INC
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Dates
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Enumeration Date | 03/12/2009
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Last Update Date | 03/12/2009
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Provider Practice Location Address
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Address Line | 8209 NW 201ST TER
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City | HIALEAH
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State | FL
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Zip | 33015-5934
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Country | US
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Telephone | 305-829-3009
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Fax | 305-829-4286
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Provider Business Mailing Address
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Address Line | 8209 NW 201ST TER
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City | HIALEAH
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State | FL
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Zip | 33015-5934
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Country | US
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Telephone | 305-829-3009
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Fax | 305-829-4286
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. ROBERTO DESDIN
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Credential | PHD
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Telephone | 305-829-3009
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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 | PY 3992
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License Number State | FL
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