MEDICARE: DR. MARGARITA E GURRI 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
1	103TC0700X	Clinical Psychologist	PY 6626	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	54897	OTHER	FL	BCBS PROVIDER NUMBER

General Provider Information

NPI Number	:	1710951132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARGARITA E GURRI PH.D.

Provider Business Mailing Address
First Line	:	38 S FEDERAL HWY
Second Line	:	NO. 5
City	:	DANIA BEACH
State	:	FL
Zip	:	33004-3648
Country	:	US
Telephone Number	:	954-609-9904
Fax Number	:	954-923-1399

Provider Business Practice Location Address
First Line	:	38 S FEDERAL HWY
Second Line	:	NO. 5
City	:	DANIA BEACH
State	:	FL
Zip	:	33004-3648
Country	:	US
Telephone Number	:	954-609-9904
Fax Number	:	954-923-1399

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	07/08/2007

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