Provider Demographics
NPI:1821167594
Name:HARVEY, MYRON ANTHONY (PHD)
Entity Type:Individual
Prefix:DR
First Name:MYRON
Middle Name:ANTHONY
Last Name:HARVEY
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 1:8430 POINCIANA PL
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32963-4232
Mailing Address - Country:US
Mailing Address - Phone:772-360-7267
Mailing Address - Fax:
Practice Address - Street 1:8430 POINCIANA PL
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32963-4232
Practice Address - Country:US
Practice Address - Phone:772-360-7267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 2269103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist