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Organization

CARMEN CORNIDE, PSY.D., P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CARMEN CORNIDE PSY.D. (PRESIDENT)
(954) 443-0018
Entity
Organization

Contact information

Practice address
1601 N PALM AVE, SUITE 300, PEMBROKE PINES, FL 33026-3200
(954) 443-0018
(954) 236-6331
Mailing address
1601 N PALM AVE, SUITE 300, PEMBROKE PINES, FL 33026-3200
(954) 443-0018
(954) 236-6331

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY5595
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
54131
MEDICARE PROVIDER NUMBER
FL
Enumeration date
07/06/2015
Last updated
07/07/2015
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