MEDICARE: DR. CHERI GAY SURLOFF PHD.,PSYD

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	103G00000X	Clinical Neuropsychologist	PY5918	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770507121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHERI GAY SURLOFF PHD.,PSYD

Provider Business Mailing Address
First Line	:	501 PALM DR
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-6533
Country	:	US
Telephone Number	:	954-456-7429
Fax Number	:	954-456-0949

Provider Business Practice Location Address
First Line	:	501 PALM DR
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-6533
Country	:	US
Telephone Number	:	954-456-7429
Fax Number	:	954-456-0949

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	07/09/2007

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Directions to “ DR. CHERI GAY SURLOFF PHD.,PSYD” Practice Location

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