Provider Demographics
NPI:1083822274
Name:NEARING, GRACIELA BATISTA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:GRACIELA
Middle Name:BATISTA
Last Name:NEARING
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 S DIXIE HWY
Mailing Address - Street 2:SUITE 104-A
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-2456
Mailing Address - Country:US
Mailing Address - Phone:305-250-9930
Mailing Address - Fax:
Practice Address - Street 1:2000 S DIXIE HWY
Practice Address - Street 2:SUITE 104-A
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2456
Practice Address - Country:US
Practice Address - Phone:305-250-9930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6358103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical