MEDICARE: SHERIDAN PSYCHOLOGY GROUP PLLC

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

General Provider Information

NPI Number	:	1871426841
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHERIDAN PSYCHOLOGY GROUP PLLC

Provider Business Mailing Address
First Line	:	2007 SAINT ANDREWS RD
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-2942
Country	:	US
Telephone Number	:	786-390-4616
Fax Number	:

Provider Business Practice Location Address
First Line	:	2007 SAINT ANDREWS RD
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-2942
Country	:	US
Telephone Number	:	786-390-4616
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	BENJAMIN GLUECK
Credential	:	PHD
Telephone Number	:	786-390-4616

Provider Enumeration Date	:	06/08/2026
Last Update Date	:	06/08/2026

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