Provider Demographics
NPI:1417995283
Name:BANK, ADAM L (PHD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:L
Last Name:BANK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:248 THREE ISLANDS BLVD
Mailing Address - Street 2:# 201
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-7330
Mailing Address - Country:US
Mailing Address - Phone:954-458-9451
Mailing Address - Fax:305-935-1717
Practice Address - Street 1:2925 AVENTURA BLVD
Practice Address - Street 2:# 203
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-3124
Practice Address - Country:US
Practice Address - Phone:305-935-6060
Practice Address - Fax:305-935-1717
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPY 7028103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU5473ZMedicare ID - Type UnspecifiedBROWARD COUNTY MEDICARE
FLU5473YMedicare ID - Type UnspecifiedMIAMI-DAD COUNTY