MEDICARE: ABBE DALE HURWITZ PSYCHOLOGIST

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	PY0004006	FL

General Provider Information

NPI Number	:	1578628020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABBE DALE HURWITZ PSYCHOLOGIST

Provider Business Mailing Address
First Line	:	5900 SW 73RD ST
Second Line	:	SUITE 102
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-5151
Country	:	US
Telephone Number	:	305-662-1725
Fax Number	:	305-661-7559

Provider Business Practice Location Address
First Line	:	5900 SW 73RD ST
Second Line	:	SUITE 102
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-5151
Country	:	US
Telephone Number	:	305-662-1725
Fax Number	:	305-661-7559

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

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	07/08/2007

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