Organization
CARY R SHOOKOFF PHD PSYCHOLOGIST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARY R SHOOKOFF PHD (DIRECTOR PRESIDENT PSYCHOLOGIST)
(305) 674-0055
Entity
Organization
Contact information
Practice address
1900 PURDY AVE STE 2, COMM. UNITS G & G, MIAMI BEACH, FL 33139-1409
(305) 674-0055
(305) 341-3935
Mailing address
1900 PURDY AVE STE 2, COMM. UNITS G & G, MIAMI BEACH, FL 33139-1409
(305) 674-0055
(305) 341-3935
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY 2924
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59 2398787
FEDERAL TAX ID
FL
01
—
73236
BLUE CROSS - MEDICARE
FL
Enumeration date
03/29/2007
Last updated
12/23/2009
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