SRM CLINICAL PSYCHOLOGY P A (NPI# 1811133309) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811133309 |
| Entity Type | Organization |
| Organization Name | SRM CLINICAL PSYCHOLOGY P A |
| Practice Address |
6100 Hollywood Blvd Suite 201 Hollywood FL 33024-7900 |
| Mailing Address |
3215 Ne 184th St Apto 14203 North Miami Beach FL 33160-4994 |
| Practice Telephone | 9549628052 |
| Practice Fax Number | 9549664774 |
| Mailing Telephone | 9549628052 |
| Mailing Fax Number | 9549664774 |
| Enumeration Date | 2009-01-05 |
| Last Update Date | 2009-08-20 |
| Authorized Official Name | SARA MALAGOLD (PRESIDENT) |
| Authorized Official Telephone | 9549628052 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 7360 | FL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | LIC | 7360 | 01 |
| Street Address |
6100 HOLLYWOOD BLVD SUITE 201 |
| City | HOLLYWOOD |
| State | FL |
| Zip Code | 33024-7900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235219833 | Mains'l Florida, Inc. Dba Mains'l Service,inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6100 Hollywood Blvd, Hollywood, FL 33024-7900 | 2006-10-17 |
| 1578116059 | One Stop Medical Supplies LLC | Durable Medical Equipment & Medical Supplies | 6100 Hollywood Blvd, Suite 522, Hollywood, FL 33024-7346 | 2019-07-23 |
| 1699233726 | Woodlane Medical LLC | Durable Medical Equipment & Medical Supplies | 6100 Hollywood Blvd, Ste 510, Hollywood, FL 33024 | 2019-03-07 |
| 1295200897 | Guidewell Sanitas I, LLC | Clinic/Center | 6100 Hollywood Blvd, Hollywood, FL 33024-7900 | 2018-10-10 |
| 1427595354 | E-lab of Florida Inc. | Clinical Medical Laboratory | 6100 Hollywood Blvd, Suite 306, Hollywood, FL 33024-7982 | 2017-01-30 |
| 1437427366 | Integrative Center for Cognitive Disorders Pa | Psychologist | 6100 Hollywood Blvd, Suite 202, Hollywood, FL 33024-7900 | 2011-12-07 |
| 1679713838 | Pain Management Group of S Florida Inc | Chiropractor | 6100 Hollywood Blvd, Suite 409, Hollywood, FL 33024-7900 | 2009-03-02 |
| 1396980892 | Hugo De Ayala | Specialist | 6100 Hollywood Blvd, Suite 106, Hollywood, FL 33024-7900 | 2008-12-11 |
| 1508042185 | Uro-medix Inc | Urology | 6100 Hollywood Blvd, Suite 100, Hollywood, FL 33024-7900 | 2008-01-14 |
| 1407030216 | Sara Rosa Malagold | Psychologist | 6100 Hollywood Blvd, Suite 201, Hollywood, FL 33024-7900 | 2007-12-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720603467 | Brooke Davignon | Behavioral Analyst | 1800 N Douglas Rd, Pembroke Pines, FL 33024 | 2020-06-09 |
| 1710527296 | Kids Miracle Steps, Inc. | Skilled Nursing Facility | 1371-1381 N Palm Ave., Pembroke Pines, FL 33024 | 2020-01-13 |
| 1992263636 | Cortney D Johnson | Social Worker | 1773 Nw 74th Way, Hollywood, FL 33024 | 2019-03-12 |
| 1760964613 | Family Medical Supplies LLC | Durable Medical Equipment & Medical Supplies | 7777 Davie Rd Ext, Ste 302 A-z, Hollywood, FL 33024 | 2018-09-06 |
| 1639650427 | Delone Elizabeth Plummer | Nurse Practitioner | 3157 N Univesity Dr, Pembroke Pines, FL 33024 | 2018-08-28 |
| 1467943126 | Bl Medical Center, Inc | Dermatology | 9050 Pines Blvd Ste 363, Pembroke Pines, FL 33024 | 2018-05-29 |
| 1952890360 | Rosmery Perez | Behavior Technician | 6610 Meade St, Hollywood, FL 33024 | 2018-05-02 |
| 1447747134 | Joseph P Robert | Technician, Health Information | 8471 Nw19th St, Pembroke Pines, FL 33024 | 2018-04-18 |
| 1164929329 | Yanelis Gutierrez Rodriguez | Behavior Technician | 321 Nw 78t Terrace Apt 104, Apt104 B32, Pembroke Pines, FL 33024 | 2018-04-12 |
| 1134621949 | Llc Tm's Care Enterprise | Clinic/Center | 9113-9117 Taft Street, Pembroke Pines, FL 33024 | 2018-03-07 |
| Find all providers in zip 33024 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245656792 | South Broward Hospital District | Clinical Neuropsychologist | 3600 Washington St Ste 1005, Hollywood, FL 33021-8216 | 2014-03-07 |
| 1538385919 | Jacqueline C Valdes | Clinical Neuropsychologist | 2214 Hollywood Blvd, Hollywood, FL 33020-6702 | 2007-04-17 |
| 1962528133 | William A Sherman Jr. | Clinical Neuropsychologist | 44610 Smiths Nursery Rd, Hollywood, MD 20636-2902 | 2007-03-21 |
| 1336258144 | Steven Lloyd Ganzell | Clinical Neuropsychologist | 6115 Selma Ave, Suite 200, Hollywood, CA 90028-6440 | 2006-08-29 |
| 1831177435 | Jacqueline Chehebar-valdes Phd Pa | Clinical Neuropsychologist | 2214 Hollywood Boulevard, Hollywood, FL 33020 | 2006-01-04 |
| 1629589833 | Cristina Carolina Santiago | Clinical Neuropsychologist | 1150 N 35th Ave Ste 520, Hollywood, FL 33021-5431 | 2017-10-14 |
| 1023401932 | Marian Rosado | Clinical Neuropsychologist | 3600 Washington St Ste 1005, Hollywood, FL 33021-8216 | 2015-03-17 |
| 1275826125 | Thomas A. Crum, Ph.d., Pa | Clinical Neuropsychologist | 450 N Park Rd, Suite 502, Hollywood, FL 33021-6917 | 2011-05-25 |
| 1447559448 | Center for Neuropsychological Assessment Services LLC | Clinical Neuropsychologist | 3501 Johnson St, Hollywood, FL 33021-5421 | 2011-03-16 |
| 1740583582 | Christina Maria Zafiris | Clinical Neuropsychologist | 4651 Sheridan St, Ste 150, Hollywood, FL 33021-3457 | 2010-12-17 |
| Find all providers in HOLLYWOOD | ||||
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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.