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General NPI Number Information
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NPI Number | 1992862825
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Entity Type | Individual
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Provider Name | JOSEPH JOHN CIMINO PSYD
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Gender | Male
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 04/21/2014
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Provider Practice Location Address
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Address Line | 1500 N UNIVERSITY DR SUITE 202
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-8914
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Country | US
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Telephone | 954-755-4778
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Fax | 954-755-0240
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Provider Business Mailing Address
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Address Line | 1500 N UNIVERSITY DR SUITE 202
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-8914
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Country | US
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Telephone | 954-755-4778
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Fax | 954-755-0240
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY0004734
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License Number State | FL
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