Provider Demographics
NPI:1154478022
Name:FLEISCHMANN-NAIDI, JOAN (PHD)
Entity type:Individual
Prefix:DR
First Name:JOAN
Middle Name:
Last Name:FLEISCHMANN-NAIDI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7401
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33482-7401
Mailing Address - Country:US
Mailing Address - Phone:561-272-6102
Mailing Address - Fax:561-795-5004
Practice Address - Street 1:12989 SOUTHERN BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-9211
Practice Address - Country:US
Practice Address - Phone:561-272-6102
Practice Address - Fax:561-795-5004
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5074103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL59637Medicare ID - Type Unspecified