Provider Demographics
NPI:1558446567
Name:WEST PSYCHIATRIC ASSOCIATES P A
Entity Type:Organization
Organization Name:WEST PSYCHIATRIC ASSOCIATES P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAYONARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-499-2535
Mailing Address - Street 1:600 N HIATUS RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-5207
Mailing Address - Country:US
Mailing Address - Phone:954-499-2535
Mailing Address - Fax:954-435-6614
Practice Address - Street 1:600 N HIATUS RD
Practice Address - Street 2:SUITE 201
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-5207
Practice Address - Country:US
Practice Address - Phone:954-499-2535
Practice Address - Fax:954-435-6614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME750242084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H06886Medicare UPIN
K2094Medicare ID - Type Unspecified