Provider Demographics
NPI:1942414149
Name:REISLER, STEVEN ELLIOT (PSYD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ELLIOT
Last Name:REISLER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 W PALMETTO PARK RD
Mailing Address - Street 2:SUITE 205A
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3458
Mailing Address - Country:US
Mailing Address - Phone:561-239-4062
Mailing Address - Fax:561-544-8860
Practice Address - Street 1:7301 W PALMETTO PARK RD
Practice Address - Street 2:SUITE 205A
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3458
Practice Address - Country:US
Practice Address - Phone:561-239-4062
Practice Address - Fax:561-544-8860
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7338103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAC624Medicare PIN