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General NPI Number Information
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NPI Number | 1104224211
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Entity Type | Individual
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Provider Name | EDAN M ALCALAY PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 12/06/2014
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 950 PENINSULA CORPORATE CIR STE 3024
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City | BOCA RATON
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State | FL
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Zip | 33487-1388
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Country | US
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Telephone | 561-350-4464
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Fax |
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Provider Business Mailing Address
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Address Line | 950 PENINSULA CORPORATE CIR STE 3024
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City | BOCA RATON
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State | FL
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Zip | 33487-1388
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Country | US
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Telephone | 561-350-4464
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | PY9131
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY9131
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License Number State | FL
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