Individual
DR. BLAISE AMENDOLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D
Contact information
Practice address
9780 NW 5TH CT, CORAL SPRINGS, FL 33071-6817
(321) 243-8218
Mailing address
9780 NW 5TH CT, CORAL SPRINGS, FL 33071-6817
(321) 243-8218
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY8603
FL
Other
Enumeration date
10/08/2019
Last updated
10/08/2019
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