Individual
DR. MICHAEL JOHN DITOMASSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
13834 SW 122ND CT, MIAMI, FL 33186-6052
(305) 256-4324
(305) 256-5610
Mailing address
13834 SW 122ND CT, MIAMI, FL 33186-6052
(305) 256-4324
(305) 256-5610
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY-5449
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7672951 00
—
FL
Enumeration date
12/03/2009
Last updated
12/03/2009
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