MEDICARE: DR. DEBORAH LEE RADZWILL 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
1	103TC0700X	Clinical Psychologist	PY 7029	FL

General Provider Information

NPI Number	:	1053524314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBORAH LEE RADZWILL PSY.D.

Provider Business Mailing Address
First Line	:	22296 CALIBRE CT
Second Line	:	APARTMENT 1502
City	:	BOCA RATON
State	:	FL
Zip	:	33433-5562
Country	:	US
Telephone Number	:	561-706-2854
Fax Number	:

Provider Business Practice Location Address
First Line	:	3119 WATERSIDE CIR
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33435-6403
Country	:	US
Telephone Number	:	561-706-2854
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	06/03/2024

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