Provider Demographics
NPI:1700379534
Name:PSYCHWAYS
Entity Type:Organization
Organization Name:PSYCHWAYS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSIMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:SALDANA TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-656-3604
Mailing Address - Street 1:1555 BONAVENTURE BLVD STE 1022
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-4041
Mailing Address - Country:US
Mailing Address - Phone:954-656-3604
Mailing Address - Fax:
Practice Address - Street 1:1555 BONAVENTURE BLVD STE 1022
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-4041
Practice Address - Country:US
Practice Address - Phone:954-656-3604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-06
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8766103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty