MEDICARE: DR. ESTHER L MISDRAJI 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	103T00000X	Psychologist	PY7871	FL

General Provider Information

NPI Number	:	1487896577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ESTHER L MISDRAJI PSY.D.

Provider Business Mailing Address
First Line	:	19720 NE 24TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33180-2143
Country	:	US
Telephone Number	:	305-772-0215
Fax Number	:	305-935-1614

Provider Business Practice Location Address
First Line	:	19720 NE 24TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33180-2143
Country	:	US
Telephone Number	:	305-772-0215
Fax Number	:	305-935-1614

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

Provider Enumeration Date	:	04/03/2009
Last Update Date	:	04/03/2009

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