Organization
PSYCHOLOGICAL SPECIALISTS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEONARD I JACOBSON PH.D. (PRESIDENT)
(305) 667-4724
Entity
Organization
Contact information
Practice address
7000 SW 62ND AVE PH L, SOUTH MIAMI, FL 33143-4721
(305) 667-4724
(305) 667-8599
Mailing address
7000 SW 62ND AVE PH L, SOUTH MIAMI, FL 33143-4721
(305) 667-4724
(305) 667-8599
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
FL PY0002309
FL
Other
Enumeration date
04/08/2008
Last updated
04/23/2008
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