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General NPI Number Information
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NPI Number | 1912216508
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Entity Type | Organization
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Legal Business Name | BENJAMIN ALGAZE, PH.D., P.A.
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Dates
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Enumeration Date | 09/29/2010
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Last Update Date | 11/18/2010
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Provider Practice Location Address
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Address Line | 21304 NE 19TH CT
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City | MIAMI
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State | FL
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Zip | 33179-1517
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Country | US
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Telephone | 305-586-2686
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Fax | 786-320-5475
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Provider Business Mailing Address
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Address Line | 21304 NE 19TH CT
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City | MIAMI
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State | FL
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Zip | 33179-1517
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Country | US
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Telephone | 305-586-2686
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Fax | 786-320-5475
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BENJAMIN ALGAZE
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Credential | PH.D.
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Telephone | 305-586-2686
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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 | PY3339
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License Number State | FL
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