Provider Demographics
NPI:1134148117
Name:PROFESSIONAL ASSOCIATES FOR THERAPY & TESTING SERVICES INC
Entity type:Organization
Organization Name:PROFESSIONAL ASSOCIATES FOR THERAPY & TESTING SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURENCE
Authorized Official - Middle Name:L
Authorized Official - Last Name:DAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:954-431-1709
Mailing Address - Street 1:1876 ANDROMEDA LN
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327-2220
Mailing Address - Country:US
Mailing Address - Phone:954-431-1709
Mailing Address - Fax:
Practice Address - Street 1:1560 SAWGRASS CORPORATE PKWY
Practice Address - Street 2:4TH FLOOR
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-2858
Practice Address - Country:US
Practice Address - Phone:954-431-1709
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLR04059Medicare UPIN
FLAE104Medicare PIN