Provider Demographics
NPI:1699810150
Name:NUDELMAN, CILA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CILA
Middle Name:
Last Name:NUDELMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2780 NE 183RD ST
Mailing Address - Street 2:APT 2015
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33160-2157
Mailing Address - Country:US
Mailing Address - Phone:305-926-5000
Mailing Address - Fax:
Practice Address - Street 1:1011 IVES DAIRY RD
Practice Address - Street 2:BLDG 2 SUITE 208
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33179-2536
Practice Address - Country:US
Practice Address - Phone:305-653-0098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 6569103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical