Provider Demographics
NPI:1477997153
Name:MIAZGOWICZ, FLORENCE JEAN (MA)
Entity Type:Individual
Prefix:MRS
First Name:FLORENCE
Middle Name:JEAN
Last Name:MIAZGOWICZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 NW 15TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1431
Mailing Address - Country:US
Mailing Address - Phone:305-325-1818
Mailing Address - Fax:305-325-1151
Practice Address - Street 1:750 NW 15TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1431
Practice Address - Country:US
Practice Address - Phone:305-325-1818
Practice Address - Fax:305-325-1151
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist