Active NPI
Palmwood Center for Psychological Services, P.a.
- Clinical Psychologist
- Sunrise, FL
National Provider Identifier
1306055942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY0004153
- Legal business name
- PALMWOOD CENTER FOR PSYCHOLOGICAL SERVICES, P.A.
- Practice address
- 8890 W Oakland Park Blvd
Suite #103
Sunrise, FL 33351-7235 - Phone
- (954) 742-7032
- Fax
- (954) 742-7868
- NPI assigned
- May 21, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Alec Roth, PH.D.
- Title
- Licensed Psychologist
- Phone
- (954) 742-7032
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY0004153 | FL | Primary |
Addresses
Primary practice location
8890 W Oakland Park Blvd
Suite #103
Sunrise, FL 33351-7235
Mailing address
8890 W Oakland Park Blvd
Suite #103
Sunrise, FL 33351-7235
Phone (954) 742-7032
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
8890 W Oakland Park Blvd
Ste 103
Sunrise, FL 33351
Phone (954) 742-7032
Networks
- HealthSun Health Plans Network
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychologist
- Sunrise, FL
- NPI 1306832027
-
- Clinical Psychologist
- Sunrise, FL
- NPI 1235781873
-
- Psychologist
- Sunrise, FL
- NPI 1780670539
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1303862400000",
"number": "1306055942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8890 W OAKLAND PARK BLVD",
"address_2": "SUITE #103",
"city": "SUNRISE",
"state": "FL",
"postal_code": "333517235",
"telephone_number": "954-742-7032",
"fax_number": "954-742-7868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8890 W OAKLAND PARK BLVD",
"address_2": "SUITE #103",
"city": "SUNRISE",
"state": "FL",
"postal_code": "333517235",
"telephone_number": "954-742-7032",
"fax_number": "954-742-7868"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PALMWOOD CENTER FOR PSYCHOLOGICAL SERVICES, P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-21",
"last_updated": "2011-04-27",
"status": "A",
"authorized_official_last_name": "ROTH",
"authorized_official_first_name": "ALEC",
"authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
"authorized_official_telephone_number": "954-742-7032",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PH.D."
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY0004153",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sunrise, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.