PSYCHOLOGICAL SPECIALISTS PA
Psychologist at 62 Ave, Miami, FL

License number
Florida FL PY0002309
Category
Psychologist
Type
Psychologist
Owner
Name: DR. LEONARD I JACOBSON PH.D.
Title: PRESIDENT
Phone: (305) 667-4724
Address
Address
7000 SW 62Nd Ave PH L, Miami, FL 33143
National Provider ID: 1154594547
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PSYCHOLOGICAL SPECIALISTS, PA

Miami, FL

Status:
Inactive
Industry:
Psychologist Office
Inactive reason:
VOLUNTARY DISSOLUTION
Registration:
Nov 24, 1987
Inactive since:
Jan 24, 2013
Phone:
(305) 667-4724 (Phone)
Addresses:
7000 SW 62 Ave The Penthouse SUITE L, Miami, FL 33143 (Physical)
7000 SW 62 Ave, Miami, FL 33143
State ID:
K03754
Business type:
Florida Profit Corporation
President, Directors:
Jacobson, Leonard I, Ph.d, 7000 SW 62 Ave, Miami, FL 33143 (Physical),Antonio Hernandez President, Director, Vice President, inactive, 7000 SW 62 Ave, Miami, FL 33143 (Physical),Leonard I. Jacobson President, Director, inactive
Agent:
Jacobson, Leonard I., Ph.d,7000 SW 62 Ave, Miami, FL 33143 (Physical)
EIN:
65-0016690

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