DR. LYDIA ROSA MALCOLM (NPI# 1598267809) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598267809 |
| Entity Type | Individual |
| Full Name | DR. LYDIA ROSA MALCOLM |
| Credential | PHD |
| Practice Address |
11820 Miramar Pkwy Ste 309 Miramar FL 33025 |
| Mailing Address |
18459 Pines Blvd # 120 Pembroke Pines FL 33029-1400 |
| Practice Telephone | 9547155477 |
| Mailing Telephone | 9547155477 |
| Enumeration Date | 2018-03-02 |
| Last Update Date | 2020-09-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PY10094 | FL | Behavioral Health & Social Service Providers |
| Street Address |
11820 MIRAMAR PKWY STE 309 |
| City | MIRAMAR |
| State | FL |
| Zip Code | 33025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487157715 | Authentic Behavioral Health, LLC | Psychologist | 11820 Miramar Pkwy Ste 309, Miramar, FL 33025 | 2018-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538702329 | Ashley V Carter | Nutritionist | 3803 Sw 93rd Ave, Miramar, FL 33025 | 2019-10-24 |
| 1477024305 | Jeff Rocker | Counselor | 10700 City Center Blvd Apt 5245, Pembroke Pines, FL 33025 | 2018-12-17 |
| 1760959779 | Spring Health Inc | In Home Supportive Care | 1799 Sw 82nd Pl, Miramar, FL 33025 | 2018-10-28 |
| 1649763004 | Ann-marie Elizabeth Pryce | Nurse Practitioner | 8942 Sw 19th St, Miramar, FL 33025 | 2018-06-11 |
| 1588154876 | Michelle Angelle Crawford | Behavior Technician | 10630 Washington St Apt 103, Pembroke Pines, FL 33025 | 2018-05-14 |
| 1447760657 | At Talitha Cumi Home Care, Inc. | Homemaker | 3140 Sw 120 Terr, Miramar, FL 33025 | 2017-10-03 |
| 1962924522 | Yenni Celina Cueto | Behavioral Analyst | 720 Sw 111th Ave Apt 303, Pembroke Pines, FL 33025 | 2017-07-14 |
| 1093236713 | Manoucheca Fabienne Phanord | Nurse Practitioner | 11575 City Hall Promenade, #4-150, Miramar, FL 33025 | 2017-07-03 |
| 1659801439 | Desiree Verina Nugent | Family Medicine | 3772 Sw 93rd Ave, Miramar, FL 33025 | 2017-06-14 |
| 1184153587 | Javier Servigna | Dentist | 10620 Washington St, 104, Pembroke Pines, FL 33025 | 2017-06-08 |
| Find all providers in zip 33025 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497979009 | Lynnette Austin | Psychologist | 3601 Sw 160th Ave, Suite 250, Miramar, FL 33027-6308 | 2007-04-13 |
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|---|---|---|---|---|
| 1336740224 | North Florida Collaborative Therapy | Psychologist | 9652 Morgan Creek Ct, Jacksonville, FL 32222-5808 | 2020-11-05 |
| 1922607381 | Michelle Mcnally | Psychologist | 6945 Halton Park Ln, Coconut Creek, FL 33073-2170 | 2020-10-18 |
| 1427665322 | Salubrious Psychological Services | Psychologist | 865 Nw 208th Cir, Pembroke Pines, FL 33029-1908 | 2020-09-25 |
| 1396351979 | Daniela Oliveira De Medeiros | Psychologist | 111 Majorca Ave # B, Coral Gables, FL 33134-4508 | 2020-09-19 |
| 1235744327 | Lisa Stewart | Psychologist | 13000 Bruce B Downs Blvd Bldg 68, Tampa, FL 33612-4745 | 2020-09-15 |
| 1265047047 | Anissa York | Psychologist | 6760 Congress Ave Apt 203, Boca Raton, FL 33487-1242 | 2020-09-09 |
| 1154935781 | Caressa Alice Slocum | Psychologist | 840 Dr M.l.k. Jr St N, St. Petersburg, FL 33705 | 2020-09-01 |
| 1497365399 | Julia L Sheffler | Psychologist | 1126b Lee Ave, Tallahassee, FL 32303-6508 | 2020-08-05 |
| 1801413315 | Steven David Macchione | Psychologist | 328 Nw 97th Ave, Plantation, FL 33324-7068 | 2020-06-30 |
| 1578180154 | Lory Jean Reyes | Psychologist | 1180 N Federal Hwy Ph 1608, Fort Lauderdale, FL 33304-1470 | 2020-06-30 |
| Find all providers with the same taxonomy | ||||
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| 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.