MEDICARE: PSYCHOLOGY SPECIALISTS OF FLORIDA, LLC

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

General Provider Information

NPI Number	:	1013772276
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PSYCHOLOGY SPECIALISTS OF FLORIDA, LLC

Provider Business Mailing Address
First Line	:	2617 WARWICK PL
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73013-6551
Country	:	US
Telephone Number	:	405-818-1647
Fax Number	:

Provider Business Practice Location Address
First Line	:	3115 NW 10TH TER STE 103
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-5937
Country	:	US
Telephone Number	:	954-903-1665
Fax Number	:	954-231-8558

Authorized Official
Title or Position	:	LICENSED PSYCHOLOGIST
Name	:	DR. STEVEN STERNLOF
Credential	:	PH.D.
Telephone Number	:	954-903-1665

Provider Enumeration Date	:	02/16/2024
Last Update Date	:	02/16/2024

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