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Individual

PEYSAF WORTHALTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
20824 W DIXIE HWY, MIAMI, FL 33180-1147
(305) 654-0907
(305) 999-0011
Mailing address
20824 W DIXIE HWY, MIAMI, FL 33180-1147
(305) 654-0907
(305) 999-0011

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME41125
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
039728800
FL
01
96159
BCBS
FL
Enumeration date
09/10/2007
Last updated
05/17/2011
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