MEDICARE: ALAN A JAFFE PHD & ASSOCIATES PA

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	103TC0700X	Clinical Psychologist	PY3317	FL
2	103G00000X	Clinical Neuropsychologist	PY3317	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	75276	OTHER	FL	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326165655
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALAN A JAFFE PHD & ASSOCIATES PA

Provider Business Mailing Address
First Line	:	807 CORAL RIDGE DR
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-4180
Country	:	US
Telephone Number	:	954-755-0909
Fax Number	:	954-755-5692

Provider Business Practice Location Address
First Line	:	807 CORAL RIDGE DR
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-4180
Country	:	US
Telephone Number	:	954-755-0909
Fax Number	:	954-755-5692

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	SCOTT JAFFE
Credential	:
Telephone Number	:	954-501-4517

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	03/23/2026

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