| Cary R Shookoff Phd Psychologist Llc | |
|
1900 Purdy Ave Ste 2 Comm. Units G & G Miami Beach FL 33139-1409 | |
| (305) 674-0055 | |
| (305) 341-3935 |
| Full Name | Cary R Shookoff Phd Psychologist Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1900 Purdy Ave Ste 2, Miami Beach, Florida |
| Authorized Official Name and Position | Cary R Shookoff (DIRECTOR PRESIDENT PSYCHOLOGIST) |
| Authorized Official Contact | 3056740055 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cary R Shookoff Phd Psychologist Llc 1900 Purdy Ave Ste 2 Comm. Units G & G Miami Beach FL 33139-1409 Ph: (305) 674-0055 | Cary R Shookoff Phd Psychologist Llc 1900 Purdy Ave Ste 2 Comm. Units G & G Miami Beach FL 33139-1409 Ph: (305) 674-0055 |
| NPI Number | 1679693121 |
|---|---|
| Provider Enumeration Date | 03/29/2007 |
| Last Update Date | 12/23/2009 |
| Medicare PECOS PAC ID | 1951432392 |
|---|---|
| Medicare Enrollment ID | O20100628001017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679693121 | NPI | - | NPPES |
| 59 2398787 | Other | FL | FEDERAL TAX ID |
| 73236 | Other | FL | BLUE CROSS - MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PY 2924 (Florida) | Primary |
| Provider Name | Cary R Shookoff |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093950750 PECOS PAC ID: 9335331701 Enrollment ID: I20200622000299 |
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