MEDICARE: DR. ADELE BESNER PSY.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	103T00000X	Psychologist	PY0003561	FL

General Provider Information

NPI Number	:	1841244498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADELE BESNER PSY.D.

Provider Business Mailing Address
First Line	:	915 MIDDLE RIVER DR
Second Line	:	SUITE 204
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304-3544
Country	:	US
Telephone Number	:	954-566-0388
Fax Number	:	954-561-8331

Provider Business Practice Location Address
First Line	:	915 MIDDLE RIVER DR
Second Line	:	SUITE 204
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304-3544
Country	:	US
Telephone Number	:	954-566-0388
Fax Number	:	954-561-8331

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

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	06/02/2008

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