Individual provider Active NPI

Paola Granados-Radlick, PSY.D.

  • Clinical Child & Adolescent Psychologist
  • Miami, FL
National Provider Identifier
1801327564
Registry record updated Sep 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
PY 9808 Issued in FL
Practice address
1200 Brickell Ave Ste 850
Miami, FL 33131-3212
Phone
(786) 318-1915
NPI assigned
Mar 24, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X PY 9808 FL Primary

Addresses

Primary practice location

1200 Brickell Ave Ste 850
Miami, FL 33131-3212

Mailing address

1200 Brickell Ave Ste 850
Miami, FL 33131-3212
Phone (786) 318-1915

Other practice location 1

1695 NW 9th Ave
Suite 2516
Miami, FL 33136-1409
Phone (305) 355-7496

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY 9808FLMDClinical Child & Adolescent Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1801327564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 BRICKELL AVE STE 850",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331313212",
            "telephone_number": "786-318-1915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 BRICKELL AVE STE 850",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331313212",
            "telephone_number": "786-318-1915"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1695 NW 9th Ave",
            "address_2": "Suite 2516",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361409",
            "country_code": "US",
            "telephone_number": "305-355-7496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANADOS-RADLICK",
        "first_name": "PAOLA",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-24",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "FL",
            "license": "PY 9808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.