Provider Demographics
NPI:1801828249
Name:SEIFER, RONALD (PHD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:SEIFER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:RONALD
Other - Middle Name:
Other - Last Name:SEIFER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:7300 W CAMINO REAL
Mailing Address - Street 2:SUITE 230
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-5512
Mailing Address - Country:US
Mailing Address - Phone:561-699-7455
Mailing Address - Fax:954-340-3407
Practice Address - Street 1:7300 W CAMINO REAL
Practice Address - Street 2:SUITE 230
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-5512
Practice Address - Country:US
Practice Address - Phone:561-699-7455
Practice Address - Fax:954-340-3407
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0002585103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL74305OtherBLUE CROSS BLUE SHIELD
FL74305BMedicare ID - Type Unspecified