Individual
DR. RICARDO BUITRAGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
2281 SW 129TH AVE, MIRAMAR, FL 33027-2652
(954) 998-6535
Mailing address
2281 SW 129TH AVE, MIRAMAR, FL 33027-2652
(954) 998-6535
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PY8722
FL
103TB0200X
Cognitive & Behavioral Psychologist
PY8722
FL
103TC0700X
Clinical Psychologist
Primary
PY8722
FL
103TC2200X
Clinical Child & Adolescent Psychologist
PY8722
FL
103TF0000X
Family Psychologist
PY8722
FL
103TF0200X
Forensic Psychologist
PY8722
FL
103TP2701X
Group Psychotherapy Psychologist
PY8722
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PY8722
FLORIDA DEPARTMENT OF HEALTH PSYCHOLOGY BOARD
FL
Enumeration date
03/11/2013
Last updated
01/23/2023
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