=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891434411
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARIA CECILIA BOIX BRAGA PHD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/01/2022
-----------------------------------------------------
Last Update Date | 05/08/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6700 N ANDREWS AVE STE 101
-----------------------------------------------------
City | FORT LAUDERDALE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33309-2165
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 888-606-0086
-----------------------------------------------------
Fax | 346-223-0296
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 112 MAGNOLIA ESTATES DR
-----------------------------------------------------
City | LEAGUE CITY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77573-4719
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 888-606-0086
-----------------------------------------------------
Fax | 346-223-0296
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103G00000X
-----------------------------------------------------
Taxonomy Name | Clinical Neuropsychologist
-----------------------------------------------------
License Number | PY-13061
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 103G00000X
-----------------------------------------------------
Taxonomy Name | Clinical Neuropsychologist
-----------------------------------------------------
License Number | 39336
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------