Provider Demographics
NPI:1861456733
Name:WESTERFELD, MADELIN MARRERO (PSYD)
Entity Type:Individual
Prefix:
First Name:MADELIN
Middle Name:MARRERO
Last Name:WESTERFELD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:MADELIN
Other - Middle Name:ZIOLA
Other - Last Name:MARRERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1700 NW 49TH ST STE 125
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3750
Mailing Address - Country:US
Mailing Address - Phone:954-786-6490
Mailing Address - Fax:954-786-6540
Practice Address - Street 1:201 E SAMPLE RD
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-3502
Practice Address - Country:US
Practice Address - Phone:954-786-6490
Practice Address - Fax:954-786-6540
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6242103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P29519Medicare UPIN
FL54618ZMedicare PIN