MICAL DESTIN


Address: 1021 Sw 4th Ave, Delray Beach, FL 33444-2273
Phone: 5619451430

MICAL DESTIN (NPI# 1023516671) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1023516671
Entity Type Individual
Full Name MICAL DESTIN
Practice Address 1021 Sw 4th Ave
Delray Beach
FL 33444-2273
Practice Telephone 5619451430
Mailing Telephone 5619451430
Enumeration Date 2018-01-30
Last Update Date 2018-01-30
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TB0200X Psychologist
Specialization: Cognitive & Behavioral
D235540938430 FL Behavioral Health & Social Service Providers

Office Location

Street Address 1021 SW 4TH AVE
City DELRAY BEACH
State FL
Zip Code 33444-2273

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Taxonomy Information

Taxonomy Code 103TB0200X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Cognitive & Behavioral

Taxonomy Definition

Definition to come...
Notes: [1/1/2007: title modified]

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Competitor

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City DELRAY BEACH
Zip Code 33444

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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