Provider Demographics
NPI:1871748905
Name:MINTZER, DEBORAH (PSYD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:
Last Name:MINTZER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 N UNIVERSITY DR STE D
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-5048
Mailing Address - Country:US
Mailing Address - Phone:954-258-9785
Mailing Address - Fax:954-340-2081
Practice Address - Street 1:3000 N UNIVERSITY DR STE D
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-5048
Practice Address - Country:US
Practice Address - Phone:954-258-9785
Practice Address - Fax:954-340-2081
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-17
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7770103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL75249OtherBC/BS OF FLORIDA
FL75249OtherBC/BS OF FLORIDA