MEDICARE: DR. KENNETH ARNOTT GRUENFELD PSY.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
1	103TC0700X	Clinical Psychologist	PY7205	FL

General Provider Information

NPI Number	:	1346343332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH ARNOTT GRUENFELD PSY.D.

Provider Business Mailing Address
First Line	:	244 THREE ISLAND BLVD #207
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009
Country	:	US
Telephone Number	:	954-966-6210
Fax Number	:

Provider Business Practice Location Address
First Line	:	3860 SHERIDAN ST STE A
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-3624
Country	:	US
Telephone Number	:	954-966-6210
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	07/08/2007

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