Provider Demographics
NPI:1699097782
Name:PAICA A PSYCHOLOGICAL ASSESSMENT AND INTERVENTION FOR CHILDREN
Entity type:Organization
Organization Name:PAICA A PSYCHOLOGICAL ASSESSMENT AND INTERVENTION FOR CHILDREN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AILEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MENDOZA-FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:305-297-9445
Mailing Address - Street 1:1172 SW 85TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4058
Mailing Address - Country:US
Mailing Address - Phone:305-297-9445
Mailing Address - Fax:305-269-3989
Practice Address - Street 1:8080 W FLAGLER ST
Practice Address - Street 2:SUITE 3C
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2100
Practice Address - Country:US
Practice Address - Phone:305-297-9445
Practice Address - Fax:305-269-3989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7893261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health