# SOUTH MIAMI PSYCHOLOGY GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760708754
- **Authorized official:** DR. SUMMER L SULLIVAN PH.D. (MEMBER)
- **Authorized official phone:** (305) 662-2686

## Contact information

- **Practice address:** 1390 S DIXIE HWY STE 1305, CORAL GABLES, FL 33146-2974
- **Practice address phone:** (305) 662-2686
- **Practice address fax:** (305) 662-7091
- **Mailing address:** 1390 S DIXIE HWY STE 1305, CORAL GABLES, FL 33146-2974
- **Mailing address phone:** (305) 662-2686
- **Mailing address fax:** (305) 662-7091

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC1900X | Counseling Psychologist | PY 7923 | FL | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | PY 5818 | FL | Yes |

## Other

- **Enumeration date:** 04/15/2010
- **Last updated:** 04/15/2010