Provider Demographics
NPI:1346498961
Name:DEBORAH MINTZER PSY D PA
Entity Type:Organization
Organization Name:DEBORAH MINTZER PSY D PA
Other - Org Name:AMERICAN PSYCHOLOGICAL ASSOCIATES, INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MINTZER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:954-258-9785
Mailing Address - Street 1:1440 CORAL RIDGE DR
Mailing Address - Street 2:179
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-5433
Mailing Address - Country:US
Mailing Address - Phone:954-258-9785
Mailing Address - Fax:954-340-2081
Practice Address - Street 1:5411 N UNIVERSITY DR STE 202
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-4637
Practice Address - Country:US
Practice Address - Phone:954-752-9393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-08
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBE079Medicare PIN