Provider Demographics
NPI:1457716383
Name:SMOLARCIK, MAXIMO (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MAXIMO
Middle Name:
Last Name:SMOLARCIK
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:DR
Other - First Name:MORDECHAI
Other - Middle Name:
Other - Last Name:SMOLARCIK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:9664 W LAKE CT
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-3966
Mailing Address - Country:US
Mailing Address - Phone:561-923-0884
Mailing Address - Fax:
Practice Address - Street 1:7000 W PALMETTO PARK RD
Practice Address - Street 2:SUITE 210
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3424
Practice Address - Country:US
Practice Address - Phone:561-923-0884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-18
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist