| Alan A Jaffe Phd & Associates Pa | |
|
3080 Nw 99th Ave Suite 202 Coral Springs FL 33065-4038 | |
| (954) 755-0909 | |
| (954) 755-5692 |
| Full Name | Alan A Jaffe Phd & Associates Pa |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 3080 Nw 99th Ave, Coral Springs, Florida |
| Authorized Official Name and Position | Alan A. Jaffe (CLINICAL DIRECTOR) |
| Authorized Official Contact | 9547550909 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alan A Jaffe Phd & Associates Pa 3080 Nw 99th Ave Suite 202 Coral Springs FL 33065-4038 Ph: (954) 755-0909 | Alan A Jaffe Phd & Associates Pa 3080 Nw 99th Ave Suite 202 Coral Springs FL 33065-4038 Ph: (954) 755-0909 |
| NPI Number | 1326165655 |
|---|---|
| Provider Enumeration Date | 03/23/2007 |
| Last Update Date | 10/22/2008 |
| Medicare PECOS PAC ID | 2264590017 |
|---|---|
| Medicare Enrollment ID | O20081022000540 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326165655 | NPI | - | NPPES |
| 75276 | Other | FL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | PY3317 (Florida) | Primary |
| 103TC0700X | Psychologist - Clinical | PY3317 (Florida) | Secondary |
| Provider Name | Alan A Jaffe |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831240902 PECOS PAC ID: 3870651623 Enrollment ID: I20081022000573 |
| Provider Name | Kerry Mathos |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427540616 PECOS PAC ID: 4688023799 Enrollment ID: I20231214003274 |
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