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NPI Code Detail

MEDICARE: SANDY BERNSTEIN PH.D.

MEDICARE: SANDY BERNSTEIN PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistPY0004910FL

General Provider Information

NPI Number : 1003988072
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDY BERNSTEIN PH.D.
Provider Business Mailing Address
First Line : 6499 POWERLINE RD
Second Line : SUITE 209
City : FORT LAUDERDALE
State : FL
Zip : 33309-2069
Country : US
Telephone Number : 954-772-6677
Fax Number : 954-772-6711
Provider Business Practice Location Address
First Line : 6499 POWERLINE RD
Second Line : SUITE 209
City : FORT LAUDERDALE
State : FL
Zip : 33309-2069
Country : US
Telephone Number : 954-772-6677
Fax Number : 954-772-6711
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2006
Last Update Date : 07/08/2007

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