Provider Demographics
NPI:1083958896
Name:BENMELEH, EVA (PHD)
Entity Type:Individual
Prefix:DR
First Name:EVA
Middle Name:
Last Name:BENMELEH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 W HALLANDALE BEACH BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-5441
Mailing Address - Country:US
Mailing Address - Phone:786-383-4942
Mailing Address - Fax:
Practice Address - Street 1:221 W HALLANDALE BEACH BLVD STE 202
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-5441
Practice Address - Country:US
Practice Address - Phone:786-383-4942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-16
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8656103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical