MEDICARE: PSYCH/MED PROS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207RI0200X	Infectious Disease Physician
2	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician
3	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1023533635
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PSYCH/MED PROS, INC.

Provider Business Mailing Address
First Line	:	300 W SUNRISE BLVD STE 3
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33311-6200
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 W SUNRISE BLVD STE 3
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33311-6200
Country	:	US
Telephone Number	:	754-234-0155
Fax Number	:	954-206-6443

Authorized Official
Title or Position	:	CLINICIAN
Name	:	RICHARD STERNE
Credential	:	MSN, ARNP, FNP-BC
Telephone Number	:	754-234-0155

Provider Enumeration Date	:	08/04/2017
Last Update Date	:	08/04/2017

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Directions to “PSYCH/MED PROS, INC. ” Practice Location

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