Provider Demographics
NPI:1255483699
Name:SLONE, SHERMAN COPLAN (PSYD, ABPP)
Entity Type:Individual
Prefix:DR
First Name:SHERMAN
Middle Name:COPLAN
Last Name:SLONE
Suffix:
Gender:M
Credentials:PSYD, ABPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5046 73RD AVE
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-4350
Mailing Address - Country:US
Mailing Address - Phone:727-541-5436
Mailing Address - Fax:727-541-5484
Practice Address - Street 1:5046 73RD AVE
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-4350
Practice Address - Country:US
Practice Address - Phone:727-541-5436
Practice Address - Fax:727-541-5484
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY3613103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL73680ZMedicare ID - Type Unspecified