DR. LOURDES PORTALES DALE (NPI# 1952927600) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952927600 |
| Entity Type | Individual |
| Full Name | DR. LOURDES PORTALES DALE |
| Credential | PHD |
| Practice Address |
580 W 8th St Fl Towerii6 Jacksonville FL 32209-6533 |
| Mailing Address |
830-13 A1a North #690 Ponte Vedra Beach FL 32082 |
| Practice Telephone | 8603052908 |
| Mailing Telephone | 8603052908 |
| Enumeration Date | 2020-06-18 |
| Last Update Date | 2020-06-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | 002436 | CT | Behavioral Health & Social Service Providers |
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
10538 | FL | Behavioral Health & Social Service Providers |
| Street Address |
580 W 8TH ST FL TOWERII6 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32209-6533 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710506183 | Hayley M Shade | Student in an Organized Health Care Education/Training Program | 655 8th St. W., 4th Floor, Lrc 653-1 West 8th Street, L18, Jacksonville, FL 32209 | 2020-04-15 |
| 1407484629 | Micah Christine Turpeau | Student in an Organized Health Care Education/Training Program | 580 W. 8th St., Tower II, Suite 6005, Jacksonville, FL 32209 | 2020-04-01 |
| 1730716366 | Nikki Javia | Student in an Organized Health Care Education/Training Program | 653-1 W 8th St, Fl 4, Lrc Box L16, Jacksonville, FL 32209 | 2020-03-24 |
| 1336776061 | Samuel Kamoroff | Student in an Organized Health Care Education/Training Program | 653-1 West 8th Street, 4th Floor, Lrc Box L16, Jacksonville, FL 32209 | 2020-03-24 |
| 1376194092 | Donald Wayne Johnson Jr. | Pharmacist | Uf Health Jacksonville, 655 West 8th Street, Jacksonville, FL 32209 | 2019-09-24 |
| 1871141838 | Anton Daran Armstrong | Counselor | 921 N. Davis St. Bldg. B, Suite 350, Jacksonville, FL 32209 | 2019-09-03 |
| 1295296499 | Christian King | Student in an Organized Health Care Education/Training Program | 580 W. 8th St., Tower II, Suite 6005, Jacksonville, FL 32209 | 2019-03-29 |
| 1013478403 | David William Barton | Orthopaedic Surgery | 655 W 8th St, Box C-126, Jacksonville, FL 32209 | 2019-03-27 |
| 1912497108 | Lisa Jordan | Adult Companion | 1515 W 31st St, Jacksonville, FL 32209 | 2018-05-14 |
| 1275020968 | Eloisa Anne Ello-esma | Nurse Practitioner | W. 8th Street, Jacksonville, FL 32209 | 2018-04-18 |
| Find all providers in zip 32209 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952834574 | Noelle Vann | Psychologist | 13241 Bartram Park Blvd Unit 209, Jacksonville, FL 32258-5233 | 2017-04-10 |
| 1134577901 | Nautilus Behavioral Health, Pllc | Psychologist | 12412 San Jose Blvd, Suite 203, Jacksonville, FL 32223-8621 | 2016-06-01 |
| 1487025805 | Shana Boyle | Psychologist | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2015-10-12 |
| 1730574286 | New Path Psychology Educational and Psychological Services | Psychologist | 6320 Saint Augustine Rd Ste 6a, Jacksonville, FL 32217-2813 | 2015-04-01 |
| 1639440415 | Karina Andrea Jeifez-zagagi | Psychologist | 1650 Prudential Dr, Suite 210, Jacksonville, FL 32207-8147 | 2012-01-25 |
| 1114226974 | Parastoo F. Nabizadeh | Psychologist | 6816 Southpoint Pkwy, Suite 202, Jacksonville, FL 32216-1700 | 2011-03-19 |
| 1659674786 | Andrew Scherbarth | Psychologist | 6867 Southpoint Dr N Ste 106, Keystone Behavioral Pediatrics/keystone Academy, Jacksonville, FL 32216-8005 | 2010-12-12 |
| 1740597608 | Fact Specialized Services, Inc. | Psychologist | 127 Center St, Jacksonville, NC 28546-5708 | 2010-09-13 |
| 1063733467 | Madeleine J Dunn | Psychologist | 3750 San Jose Pl, Suite 35, Jacksonville, FL 32257-8858 | 2010-06-20 |
| 1134259757 | Sarah Dew-reeves | Psychologist | 12412 San Jose Blvd, Suite 203, Jacksonville, FL 32223-8621 | 2007-03-06 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32209 |
Please comment or provide details below to improve the information on DR. LOURDES PORTALES DALE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.