Miami Psychological Center PA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

MIAMI PSYCHOLOGICAL CENTER PA

Practice address

1200 N Federal Hwy Ste 200
Boca Raton, FL 33432-2813

Phone

(305) 721-3128

NPI assigned

Mar 9, 2018

Organization subpart

No

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

Authorized official

Name

Jaqueline Pardillo

Title

Owner

Phone

(786) 229-6589

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Natalie Jaspers, LCSW

  • Clinical Social Worker
  • Boca Raton, FL
  • NPI 1033406103
  Medicare reassignment NPD
• Jacqueline Y Pardillo, LMHC

  • Mental Health Counselor
  • Boca Raton, FL
  • NPI 1780825190
  Medicare reassignment NPD

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

{
    "created_epoch": "1520553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609891200000",
    "number": "1982107538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9796 NW 51ST TER",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331781910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N FEDERAL HWY STE 200",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334322813",
            "telephone_number": "305-721-3128"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8200 NW 41st St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Doral",
            "state": "FL",
            "postal_code": "331666204",
            "country_code": "US",
            "telephone_number": "786-229-6589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIAMI PSYCHOLOGICAL CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-09",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A",
        "authorized_official_last_name": "PARDILLO",
        "authorized_official_first_name": "JAQUELINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-229-6589"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Marie Mezes, DO
• MG Prime Medicine LLC
• MG Puzzle Pieces Corp
• MH SNF Opco, LLC
• MHC Area 9, LLC
• Miami Renal Institute LLC
• Salvatore G Miceli, MD
• Michael a Marks PA
• Michael a. Meddoff, DMD, PA
• Michael Horn Center Florida Corp.

• Mental Health Counselor in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; 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.

Verify at the official NPI Registry.