Provider Demographics
NPI:1508889981
Name:RABINOVITZ, SHARON (PHD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:RABINOVITZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 HACKNEY RD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3001
Mailing Address - Country:US
Mailing Address - Phone:305-389-8459
Mailing Address - Fax:
Practice Address - Street 1:100 S PINE ISLAND RD
Practice Address - Street 2:STE 230
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2613
Practice Address - Country:US
Practice Address - Phone:954-370-2140
Practice Address - Fax:954-916-1252
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY3174103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL59788ZMedicare PIN