Fabiola Audibert

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY11277 Issued in FL

Practice address

16025 Emerald Estates Dr
Weston, FL 33331-6130

Phone

(754) 444-0674

NPI assigned

Aug 19, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sunshine Mind LLC

  • Clinical Psychologist
  • Weston, FL
  • NPI 1831900349
  NPD Authorized official
• Mtca Psychological Services P.a.

  • Clinical Psychologist
  • North Miami Beach, FL
  • NPI 1740552322
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1376919860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 BAYSHORE DR APT 415",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333043976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16025 EMERALD ESTATES DR",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333316130",
            "telephone_number": "754-444-0674"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "760 Broadway",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112065317",
            "country_code": "US",
            "telephone_number": "718-963-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AUDIBERT",
        "first_name": "FABIOLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-19",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY11277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolina Gradvohl Assis, ARNP, FNP
• Associatesmd Medical Group Inc
• At Home Woundcare Inc
• Enoris Atencio-Quesada, ACUPUNCTURIST
• Michael Blake Atlas
• Anida Auguste Isma, OTR/L
• Brittany Augustin, OTR
• Farah Augustin, OTR/L
• Rosette Augustin
• Milagros Aulino

• Clinical Psychologist in Weston, FL
• Providers in Weston, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.