MEDICARE: A & B PSYCHOLOGY

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
1	103T00000X	Psychologist	PY3271	FL
2	103T00000X	Psychologist	PY2027	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1376544007	OTHER		VICTORIA AZRIN NPI
2	1700887874	OTHER		NPI FOR NATHAN AZRIN

General Provider Information

NPI Number	:	1396955894
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A & B PSYCHOLOGY

Provider Business Mailing Address
First Line	:	5151 BAYVIEW DR
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308
Country	:	US
Telephone Number	:	954-491-6984
Fax Number	:	954-491-7068

Provider Business Practice Location Address
First Line	:	5151 BAYVIEW DR
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308
Country	:	US
Telephone Number	:	954-491-6984
Fax Number	:	954-491-7068

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	DR. VICTORIA B AZRIN
Credential	:	PHD
Telephone Number	:	954-491-6984

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	06/17/2008

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Directions to “A & B PSYCHOLOGY ” Practice Location

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