Provider Demographics
NPI:1225000151
Name:ROLAND F. BESSIS, PHD PA
Entity Type:Organization
Organization Name:ROLAND F. BESSIS, PHD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROLAND
Authorized Official - Middle Name:F
Authorized Official - Last Name:BESSIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:954-926-7486
Mailing Address - Street 1:939 HOLLYWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33019-1605
Mailing Address - Country:US
Mailing Address - Phone:954-926-7486
Mailing Address - Fax:954-926-5804
Practice Address - Street 1:3400 CORAL WAY
Practice Address - Street 2:SUITE 601
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-3070
Practice Address - Country:US
Practice Address - Phone:305-538-5811
Practice Address - Fax:954-926-5804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-04
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0005053174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8280Medicare ID - Type UnspecifiedCLINICAL PSYCHOLOGIST P.A
FL59678Medicare ID - Type UnspecifiedCLINICAL PSYCHOLOGIST