Provider Demographics
NPI:1336337096
Name:SHAKED, NETTA (PHD)
Entity Type:Individual
Prefix:DR
First Name:NETTA
Middle Name:
Last Name:SHAKED
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 1:1000 5TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139
Mailing Address - Country:US
Mailing Address - Phone:786-942-9425
Mailing Address - Fax:
Practice Address - Street 1:1000 5TH ST STE 200
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-6510
Practice Address - Country:US
Practice Address - Phone:786-942-9425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7699103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist