Healthcare Provider Details

I. General information

NPI: 1891171674
Provider Name (Legal Business Name): DR EDAN M ALCALAY, PSYD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2015
Last Update Date: 04/20/2025
Certification Date: 04/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 PENINSULA CORPORATE CIR STE 3024
BOCA RATON FL
33487-1388
US

IV. Provider business mailing address

950 PENINSULA CORPORATE CIR STE 3024
BOCA RATON FL
33487-1388
US

V. Phone/Fax

Practice location:
  • Phone: 561-407-4600
  • Fax:
Mailing address:
  • Phone: 561-350-4464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY9131
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. EDAN M ALCALAY
Title or Position: OWNER/MANAGING MEMBER
Credential: PSY.D
Phone: 561-350-4464