Provider Demographics
NPI:1982891214
Name:HART, NELL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:NELL
Middle Name:
Last Name:HART
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6401 SW 87TH AVE
Mailing Address - Street 2:SUITE 114
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-2500
Mailing Address - Country:US
Mailing Address - Phone:305-213-1567
Mailing Address - Fax:
Practice Address - Street 1:6401 SW 87TH AVE
Practice Address - Street 2:SUITE 114
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-2500
Practice Address - Country:US
Practice Address - Phone:305-213-1567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7502103TC0700X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic