MEDICARE: DR. MICHELLE RENEE HINTZ PSYD, MT-BC

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	103TC2200X	Clinical Child & Adolescent Psychologist	PY7496	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093835761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELLE RENEE HINTZ PSYD, MT-BC

Provider Business Mailing Address
First Line	:	450 N PARK RD
Second Line	:	SUITE 400
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-6917
Country	:	US
Telephone Number	:	954-925-3191
Fax Number	:	954-925-3193

Provider Business Practice Location Address
First Line	:	450 N PARK RD
Second Line	:	SUITE 400
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-6917
Country	:	US
Telephone Number	:	954-925-3191
Fax Number	:	954-925-3193

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

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	05/27/2014

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