Organization
JESSY SADOVNIK PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSY SADOVNIK PSYD. (PRESIDENT)
(305) 632-0630
Entity
Organization
Contact information
Practice address
765 NE 195TH ST, MIAMI, FL 33179-3421
(305) 632-0630
Mailing address
765 NE 195TH ST, MIAMI, FL 33179-3421
(305) 632-0630
(305) 651-3463
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY6670
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AH119
PTAN
FL
01
—
U0561
PTAN
—
Enumeration date
01/10/2008
Last updated
04/08/2011
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