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NPI Code Detail

MEDICARE: DR. NICOLETTA B TESSLER PSY.D.

MEDICARE:  DR. NICOLETTA B TESSLER  PSY.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist7167FL

General Provider Information

NPI Number : 1013032135
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICOLETTA B TESSLER PSY.D.
Provider Business Mailing Address
First Line : 1175 101ST ST
Second Line : TH #5
City : BAY HARBOR ISLANDS
State : FL
Zip : 33154-1528
Country : US
Telephone Number : 305-968-2481
Fax Number :
Provider Business Practice Location Address
First Line : 1695 NW 9TH AVE
Second Line : ROOM 2415
City : MIAMI
State : FL
Zip : 33136-1409
Country : US
Telephone Number : 305-355-7250
Fax Number : 305-355-8117
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2007
Last Update Date : 07/08/2007

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