Provider Demographics
NPI:1043587603
Name:INSTITUTE FOR FAMILY DEVELOPMENT, CORP.
Entity type:Organization
Organization Name:INSTITUTE FOR FAMILY DEVELOPMENT, CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:PEDRO
Authorized Official - Last Name:REDONDO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:305-551-9669
Mailing Address - Street 1:PO BOX 521742
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33152-1742
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8370 W FLAGLER ST
Practice Address - Street 2:SUITE 232
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2094
Practice Address - Country:US
Practice Address - Phone:305-551-9669
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-28
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7540102L00000X, 103T00000X, 103TC0700X, 103TP0814X
FLPY3757103T00000X, 103TC0700X, 103TF0000X
FLPY8034103T00000X, 103TB0200X, 103TC0700X
FLPY8212103T00000X, 103TC0700X, 103TC2200X
FL103T00000X
FLPY8084103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Multi-Specialty
No103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysisGroup - Multi-Specialty