Provider Demographics
NPI:1457623100
Name:KYM MCCABE, PH.D., P.A.
Entity Type:Organization
Organization Name:KYM MCCABE, PH.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KYM
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCABE
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:786-269-6929
Mailing Address - Street 1:8882 SW 62ND TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-1616
Mailing Address - Country:US
Mailing Address - Phone:786-269-6929
Mailing Address - Fax:
Practice Address - Street 1:250 CATALONIA AVE
Practice Address - Street 2:SUITE 807
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-6735
Practice Address - Country:US
Practice Address - Phone:786-269-6929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-27
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8221103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty