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General NPI Number Information
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NPI Number | 1841275674
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Entity Type | Individual
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Provider Name | MICHAEL WESTERVELD PHD
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Gender | Male
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Dates
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Enumeration Date | 12/14/2005
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Last Update Date | 06/02/2016
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Provider Practice Location Address
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Address Line | 615 E PRINCETON ST STE 540
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City | ORLANDO
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State | FL
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Zip | 32803-1424
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Country | US
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Telephone | 407-303-8877
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Fax | 407-303-8811
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Provider Business Mailing Address
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Address Line | 615 E PRINCETON ST STE 540
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City | ORLANDO
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State | FL
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Zip | 32803-1424
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Country | US
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Telephone | 407-303-8877
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Fax | 407-303-8811
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 001601
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 001601
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PY7661
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License Number State | FL
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