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Organization

PAUL J MISKE PH D LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PAUL J MISKE PH D (OWNER)
(239) 242-0588
Entity
Organization

Contact information

Practice address
916 EL DORADO PKWY W, CAPE CORAL, FL 33914-7251
(239) 242-0588
(239) 242-9945
Mailing address
2045 SE 28TH ST, CAPE CORAL, FL 33904-3284
(239) 242-0588
(239) 242-9945

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY 6267
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
54611
BCBC OF FL PROVIDER NUMBE
DC
Enumeration date
01/26/2007
Last updated
10/15/2007
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