MEDICARE: ANGELA M CUSIMANO PHD

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	PY9068	FL

General Provider Information

NPI Number	:	1689917833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA M CUSIMANO PHD

Provider Business Mailing Address
First Line	:	8029 MURANO CIR
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-8176
Country	:	US
Telephone Number	:	561-275-5375
Fax Number	:	561-293-8329

Provider Business Practice Location Address
First Line	:	8029 MURANO CIR
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-8176
Country	:	US
Telephone Number	:	561-275-5375
Fax Number	:	561-293-8329

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

Provider Enumeration Date	:	04/05/2013
Last Update Date	:	01/19/2026

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