| Sunrise Psychology Llc | |
|
101 E Florida Ave Melbourne FL 32901-8301 | |
| (321) 984-4600 | |
| Not Available |
| Full Name | Sunrise Psychology Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 101 E Florida Ave, Melbourne, Florida |
| Authorized Official Name and Position | Mylan Kaltman (MANAGER) |
| Authorized Official Contact | 3212231231 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunrise Psychology Llc 5560 Old Dixie Hwy Unit 62 Grant FL 32949-2148 Ph: (321) 223-1231 | Sunrise Psychology Llc 101 E Florida Ave Melbourne FL 32901-8301 Ph: (321) 984-4600 |
| NPI Number | 1174094916 |
|---|---|
| Provider Enumeration Date | 12/05/2018 |
| Last Update Date | 12/05/2018 |
| Medicare PECOS PAC ID | 1557609054 |
|---|---|
| Medicare Enrollment ID | O20190207001829 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174094916 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Mylan Kaltman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861645186 PECOS PAC ID: 6901967652 Enrollment ID: I20081212000529 |
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