| Sheridan Lynn Koplow Ed D Pa | |
|
10111 W Forest Hill Blvd Suite 369 Wellington FL 33414-6108 | |
| (561) 785-7767 | |
| (561) 784-4626 |
| Full Name | Sheridan Lynn Koplow Ed D Pa |
|---|---|
| Speciality | Psychologist |
| Location | 10111 W Forest Hill Blvd, Wellington, Florida |
| Authorized Official Name and Position | Sheridan Lynn Koplow (PSYCHOLOGIST PRESIDENT) |
| Authorized Official Contact | 5617847767 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sheridan Lynn Koplow Ed D Pa 10111 W Forest Hill Blvd Suite 369 Wellington FL 33414-6108 Ph: (561) 785-7767 | Sheridan Lynn Koplow Ed D Pa 10111 W Forest Hill Blvd Suite 369 Wellington FL 33414-6108 Ph: (561) 785-7767 |
| NPI Number | 1851561997 |
|---|---|
| Provider Enumeration Date | 03/05/2008 |
| Last Update Date | 03/05/2008 |
| Medicare PECOS PAC ID | 7911947189 |
|---|---|
| Medicare Enrollment ID | O20050506000223 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851561997 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | PY6678 (Florida) | Primary |
| Provider Name | Sheridan L Koplow |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912121971 PECOS PAC ID: 7810937083 Enrollment ID: I20050507000041 |
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