Provider Demographics
NPI:1538583927
Name:NADEEN MEDVIN, PH.D., PA
Entity type:Organization
Organization Name:NADEEN MEDVIN, PH.D., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NADEEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:MEDVIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:305-815-1129
Mailing Address - Street 1:1309 OBISPO AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-3511
Mailing Address - Country:US
Mailing Address - Phone:305-815-1129
Mailing Address - Fax:305-400-5122
Practice Address - Street 1:2000 S DIXIE HWY STE 103
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2455
Practice Address - Country:US
Practice Address - Phone:305-815-1129
Practice Address - Fax:305-400-5122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-06
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5624103TA0400X, 103TB0200X, 103TC1900X, 103TE1100X, 103TF0000X, 103TH0004X, 103TR0400X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Single Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
No103TE1100XBehavioral Health & Social Service ProvidersPsychologistExercise & SportsGroup - Single Specialty
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Single Specialty
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealthGroup - Single Specialty
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitationGroup - Single Specialty