Provider Demographics
NPI:1790774974
Name:DEARMAS, VIVI (PHD)
Entity Type:Individual
Prefix:DR
First Name:VIVI
Middle Name:
Last Name:DEARMAS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12705 NW 18TH CT
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-5408
Mailing Address - Country:US
Mailing Address - Phone:954-346-7741
Mailing Address - Fax:
Practice Address - Street 1:9750 NW 33RD ST
Practice Address - Street 2:SUITE 201
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4042
Practice Address - Country:US
Practice Address - Phone:954-752-2700
Practice Address - Fax:954-752-7745
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY004786103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL59410OtherBLUE CROSS BLUE SHIELD
FL59410ZMedicare ID - Type Unspecified