Provider Demographics
NPI:1861803363
Name:PATRICIA JAEGERMAN, PSY.D.
Entity type:Organization
Organization Name:PATRICIA JAEGERMAN, PSY.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING ADMINISRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CUEVAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-675-9200
Mailing Address - Street 1:2450 HOLLYWOOD BLVD
Mailing Address - Street 2:SUITE 200A
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-6619
Mailing Address - Country:US
Mailing Address - Phone:954-325-4853
Mailing Address - Fax:
Practice Address - Street 1:2450 HOLLYWOOD BLVD
Practice Address - Street 2:SUITE 200A
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-6619
Practice Address - Country:US
Practice Address - Phone:954-325-4853
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty