| Central Florida Psychological Ser Inc | |
|
204 N Park Ave Ste 100 Sanford FL 32771-1293 | |
| (407) 330-0418 | |
| (407) 321-0059 |
| Full Name | Central Florida Psychological Ser Inc |
|---|---|
| Speciality | Psychologist |
| Location | 204 N Park Ave Ste 100, Sanford, Florida |
| Authorized Official Name and Position | Susan Cherie Sult (PRESIDENT) |
| Authorized Official Contact | 4073300418 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Florida Psychological Ser Inc Po Box 2524 Sanford FL 32772-2524 Ph: (407) 330-0418 | Central Florida Psychological Ser Inc 204 N Park Ave Ste 100 Sanford FL 32771-1293 Ph: (407) 330-0418 |
| NPI Number | 1033272133 |
|---|---|
| Provider Enumeration Date | 12/19/2006 |
| Last Update Date | 09/12/2019 |
| Medicare PECOS PAC ID | 2466558085 |
|---|---|
| Medicare Enrollment ID | O20070427000370 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033272133 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PY 3854 (Florida) | Primary |
| Provider Name | Susan Cherie Sult |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689737769 PECOS PAC ID: 1658373659 Enrollment ID: I20070425000501 |
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