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NPI Code Detail

MEDICARE: DR. BRENDA LEE KUCHINSKY P.H.D.

MEDICARE:  DR. BRENDA LEE KUCHINSKY  P.H.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
1103TC0700XClinical PsychologistPY5763FL

General Provider Information

NPI Number : 1205913977
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRENDA LEE KUCHINSKY P.H.D.
Provider Business Mailing Address
First Line : 1011 IVES DAIRY RD
Second Line : BUILDING 2 SUITE 208
City : NORTH MIAMI BEACH
State : FL
Zip : 33179-2536
Country : US
Telephone Number : 305-653-0098
Fax Number : 305-654-4412
Provider Business Practice Location Address
First Line : 1011 IVES DAIRY RD
Second Line : BUILDING 2 SUITE 208
City : NORTH MIAMI BEACH
State : FL
Zip : 33179-2536
Country : US
Telephone Number : 305-653-0098
Fax Number : 305-654-4412
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 07/08/2007

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Directions to “ DR. BRENDA LEE KUCHINSKY P.H.D.” Practice Location

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