Provider Demographics
NPI:1639881592
Name:FLORIDA PSYCHOTHERAPY GROUP LLC
Entity Type:Organization
Organization Name:FLORIDA PSYCHOTHERAPY GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICA MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALEJANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAAVEDRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-245-7609
Mailing Address - Street 1:814 SW 158TH LN
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33326-2118
Mailing Address - Country:US
Mailing Address - Phone:954-245-7609
Mailing Address - Fax:
Practice Address - Street 1:15800 PINES BLVD STE 332
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33027-1212
Practice Address - Country:US
Practice Address - Phone:954-245-7609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty