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General NPI Number Information
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NPI Number | 1881885481
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Entity Type | Organization
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Legal Business Name | AMARILIS ACEVEDO, PH.D., PA
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Dates
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Enumeration Date | 08/07/2007
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Last Update Date | 03/22/2009
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Provider Practice Location Address
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Address Line | 20801 BISCAYNE BLVD STE 403
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City | AVENTURA
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State | FL
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Zip | 33180-1423
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Country | US
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Telephone | 786-351-2663
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 277706
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City | MIRAMAR
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State | FL
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Zip | 33027-7706
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Country | US
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Telephone | 786-351-2663
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Fax | 954-430-9045
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. AMARILIS ACEVEDO
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Credential | PH.D.
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Telephone | 786-351-2663
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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 | PY5860
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License Number State | FL
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