Provider Demographics
NPI:1881142644
Name:POPOVITZ-GALE, AMBER (PSYD)
Entity type:Individual
Prefix:DR
First Name:AMBER
Middle Name:
Last Name:POPOVITZ-GALE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:POPOVITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6100 LAKE ELLENOR RD
Mailing Address - Street 2:SUITE 151 #1271
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809
Mailing Address - Country:US
Mailing Address - Phone:402-369-4835
Mailing Address - Fax:312-616-8112
Practice Address - Street 1:2454 E MICHIGAN ST STE 110
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-5059
Practice Address - Country:US
Practice Address - Phone:863-591-6556
Practice Address - Fax:312-616-8112
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-21
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY10793103TC0700X
FLPY.10793103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical