Provider Demographics
NPI:1790217883
Name:MARGOT C BERROS PSYD PL
Entity Type:Organization
Organization Name:MARGOT C BERROS PSYD PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST-MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARGOT
Authorized Official - Middle Name:
Authorized Official - Last Name:BERROS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-415-9868
Mailing Address - Street 1:1725 MAIN ST
Mailing Address - Street 2:SUITE 217
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-3667
Mailing Address - Country:US
Mailing Address - Phone:954-385-8884
Mailing Address - Fax:954-385-6911
Practice Address - Street 1:1725 MAIN ST
Practice Address - Street 2:SUITE 217
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3667
Practice Address - Country:US
Practice Address - Phone:954-385-8884
Practice Address - Fax:954-385-6911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-29
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7629103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty