Provider Demographics
NPI:1245470996
Name:ELISABETH ANN SOIFER PSYD LLC
Entity type:Organization
Organization Name:ELISABETH ANN SOIFER PSYD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELISABETH ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:SOIFER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:954-577-0913
Mailing Address - Street 1:300 S PINE ISLAND RD
Mailing Address - Street 2:SUITE 241
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2673
Mailing Address - Country:US
Mailing Address - Phone:954-577-0913
Mailing Address - Fax:954-577-0918
Practice Address - Street 1:300 S PINE ISLAND RD
Practice Address - Street 2:SUITE 241
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2673
Practice Address - Country:US
Practice Address - Phone:954-577-0913
Practice Address - Fax:954-577-0918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-20
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4870103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty