Provider Demographics
NPI:1093950750
Name:SHOOKOFF, CARY (PHD)
Entity Type:Individual
Prefix:DR
First Name:CARY
Middle Name:
Last Name:SHOOKOFF
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 PURDY AVE
Mailing Address - Street 2:# 2
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-1400
Mailing Address - Country:US
Mailing Address - Phone:305-674-0055
Mailing Address - Fax:305-341-3935
Practice Address - Street 1:1900 PURDY AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-1400
Practice Address - Country:US
Practice Address - Phone:305-674-0055
Practice Address - Fax:305-341-3935
Is Sole Proprietor?:No
Enumeration Date:2008-12-10
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 2924103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling