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DR. ROGER J LAVINE PSYD.

Exercise & Sports >> Psychologist >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1336784875

Individual Registrant:
DR. ROGER J LAVINE PSYD.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
222 COMMERCIAL BLVD STE 200  LAUDERDALE BY THE SEA, FL 33308-4483 US
Tel: 954-716-6702  Fax: --

Contact information for business:
2808 NE 33RD CT APT 203  FORT LAUDERDALE, FL 33306-3014 US
Tel: 954-716-6702  Fax: --

Registration Information:
NPI: 1336784875
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N103TE1100XBehavioral Health & Social Service Providers
Psychologist
Exercise & Sports
FLPY10647
N103TF0000XBehavioral Health & Social Service Providers
Psychologist
FLPY10647
N103TP2701XBehavioral Health & Social Service Providers
Psychologist
FLPY10647
Y103TC0700XBehavioral Health & Social Service Providers
Psychologist
FLPY10647

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS FL - Page 1



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