| South Miami Psychology Group | |
|
1390 S Dixie Hwy Ste 1305 Coral Gables FL 33146-2974 | |
| (305) 662-2686 | |
| (305) 662-7091 |
| Full Name | South Miami Psychology Group |
|---|---|
| Speciality | Psychologist - Clinical Child & Adolescent |
| Location | 1390 S Dixie Hwy Ste 1305, Coral Gables, Florida |
| Authorized Official Name and Position | Summer L Sullivan (MEMBER) |
| Authorized Official Contact | 3056622686 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Miami Psychology Group 1390 S Dixie Hwy Ste 1305 Coral Gables FL 33146-2974 Ph: (305) 662-2686 | South Miami Psychology Group 1390 S Dixie Hwy Ste 1305 Coral Gables FL 33146-2974 Ph: (305) 662-2686 |
| NPI Number | 1760708754 |
|---|---|
| Provider Enumeration Date | 04/15/2010 |
| Last Update Date | 04/15/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760708754 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | PY 7923 (Florida) | Secondary |
| 103TC2200X | Psychologist - Clinical Child & Adolescent | PY 5818 (Florida) | Primary |
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