Provider Demographics
NPI:1386169563
Name:ELEANOR ZIMMERMAN, PSY.D., PLLC
Entity type:Organization
Organization Name:ELEANOR ZIMMERMAN, PSY.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSE PSYCHOLOGIST, NEUROPSYCH.
Authorized Official - Prefix:DR
Authorized Official - First Name:ELEANOR
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIMMERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:850-558-5750
Mailing Address - Street 1:12273 US HIGHWAY 98 W STE 204
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32550-6944
Mailing Address - Country:US
Mailing Address - Phone:850-558-5750
Mailing Address - Fax:844-364-1288
Practice Address - Street 1:12273 US HIGHWAY 98 W STE 204
Practice Address - Street 2:
Practice Address - City:MIRAMAR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32550-6944
Practice Address - Country:US
Practice Address - Phone:850-558-5750
Practice Address - Fax:844-364-1288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-08
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty