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Individual

MR. IVAN FLEISHMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSY.D

Contact information

Practice address
339 W NEW YORK AVE, DELAND, FL 32720-5425
(386) 736-8337
(386) 736-8336
Mailing address
339 W NEW YORK AVE, DELAND, FL 32720-5425
(386) 736-8337
(386) 736-8336

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY 3327
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
75796
BLUE CROSS BLUE SHIELD OF FLORIDA
FL
Enumeration date
12/17/2008
Last updated
12/17/2008
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