| Doctor Name: | DR. ELIZABETH CARMEN PENELA |
| NPI Number: | 1003299462 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 9177 |
| Business Practice Address: | 7301 Wiles Rd Ste 106 Coral Springs, FL - 330674105 |
| Business Phone Number: | 9547531112 |
| Business Fax Number: | 3059361022 |
| Mailing Address: | 736 Nw 164th Ave, PEMBROKE PINES |
| State: | FL |
| Postal Code: | 330281127 |
| Phone Number: | 9543094088 |
| Fax Number: | |
| NPI Enumeration Date: | 07/02/2015 |
| NPI Last Update Date: | 07/02/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 9177 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |