SRM Clinical Psychology P a

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

7360 Issued in FL

Legal business name

SRM CLINICAL PSYCHOLOGY P A

Practice address

6100 Hollywood Blvd
Suite 201
Hollywood, FL 33024-7900

Phone

(954) 962-8052

Fax

(954) 966-4774

NPI assigned

Jan 5, 2009

Last updated

Aug 20, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sara MalagoldNPI 1407030216

Title

President

Phone

(954) 962-8052

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sara Rosa Malagold, PH.D.

  • Clinical Psychologist
  • Hollywood, FL
  • NPI 1407030216
  Authorized official Same address or phone

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

{
    "created_epoch": "1231113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250726400000",
    "number": "1811133309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3215 NE 184TH ST",
            "address_2": "APTO 14203",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331604994",
            "telephone_number": "954-962-8052",
            "fax_number": "954-966-4774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 HOLLYWOOD BLVD",
            "address_2": "SUITE 201",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330247900",
            "telephone_number": "954-962-8052",
            "fax_number": "954-966-4774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRM CLINICAL PSYCHOLOGY P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-05",
        "last_updated": "2009-08-20",
        "status": "A",
        "authorized_official_last_name": "MALAGOLD",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-962-8052"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "7360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC",
            "identifier": "7360",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dennis M Spiller, DO
• Spine Sentric
• Mindy Sporn, PA-C
• Sports Injury Rehabilitation Center
• Denneshia Spratt
• William Aziz Srouji Jr., MD
• Alexandra Srour
• Daniel St Jean
• St Jude Medical Group Corp (Vidamax Medical Center)
• St Jude Medical Group Corp (Vidamax Medical Center)

• Clinical Neuropsychologist in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Clinical Neuropsychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2009; 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.