Provider Demographics
NPI:1518357854
Name:ANDREW LAGOMASINO, PSYD, PA
Entity Type:Organization
Organization Name:ANDREW LAGOMASINO, PSYD, PA
Other - Org Name:CORAL GABLES THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:LAGOMASINO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:786-543-2313
Mailing Address - Street 1:250 CATALONIA AVE STE 607
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-6727
Mailing Address - Country:US
Mailing Address - Phone:786-543-2313
Mailing Address - Fax:
Practice Address - Street 1:250 CATALONIA AVE STE 607
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-6727
Practice Address - Country:US
Practice Address - Phone:786-543-2313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6918261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health