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Organization
SOUTH MIAMI PSYCHOLOGY GROUP
Active
Organization
SOUTH MIAMI PSYCHOLOGY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUMMER L SULLIVAN PH.D. (MEMBER)
(305) 662-2686
Entity
Organization
Contact information
Practice address
1390 S DIXIE HWY STE 1305, CORAL GABLES, FL 33146-2974
(305) 662-2686
(305) 662-7091
Mailing address
1390 S DIXIE HWY STE 1305, CORAL GABLES, FL 33146-2974
(305) 662-2686
(305) 662-7091
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
PY 7923
FL
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PY 5818
FL
Other
Enumeration date
04/15/2010
Last updated
04/15/2010
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