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Organization

MICHAEL PLASENCIA, PSYD, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL ANTHONY PLASENCIA PSY.D. (PRESIDENT)
(954) 559-9201
Entity
Organization

Contact information

Practice address
10406 TAFT ST, PEMBROKE PINES, FL 33026-2819
(954) 436-3880
(954) 436-3881
Mailing address
10406 TAFT ST, PEMBROKE PINES, FL 33026-2819
(954) 436-3880
(954) 436-3881

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
024003800
FL
Enumeration date
12/17/2019
Last updated
12/17/2019
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