Provider Demographics
NPI:1790191419
Name:PATTON PSYCHOLOGY ASSOCIATES, INC.
Entity Type:Organization
Organization Name:PATTON PSYCHOLOGY ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CLINICAL NEUROPSYCHOLOGIS
Authorized Official - Prefix:DR
Authorized Official - First Name:DOYLE
Authorized Official - Middle Name:E
Authorized Official - Last Name:PATTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:786-519-1088
Mailing Address - Street 1:17501 BISCAYNE BLVD STE 450
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4806
Mailing Address - Country:US
Mailing Address - Phone:786-519-1088
Mailing Address - Fax:305-933-5733
Practice Address - Street 1:17501 BISCAYNE BLVD STE 450
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33160-4806
Practice Address - Country:US
Practice Address - Phone:786-519-1088
Practice Address - Fax:305-933-5733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-02
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6970103G00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty