MEDICARE: DR. RIMA JAKUC 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	101Y00000X	Counselor	MH 2931	FL
2	103TC0700X	Clinical Psychologist	PY7597	FL

General Provider Information

NPI Number	:	1972526341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RIMA JAKUC PSYD

Provider Business Mailing Address
First Line	:	2147 MAN OF WAR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33411
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1825 FOREST HILL BLVD
Second Line	:	SUITE 105
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-8902
Country	:	US
Telephone Number	:	561-379-3650
Fax Number	:	561-641-0168

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

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	01/04/2008

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