Provider Demographics
NPI:1932197548
Name:KUMAR, SAMEET (PHD)
Entity Type:Individual
Prefix:
First Name:SAMEET
Middle Name:
Last Name:KUMAR
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 1:1150 N 35TH AVENUE
Mailing Address - Street 2:SUITE 170
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021
Mailing Address - Country:US
Mailing Address - Phone:954-265-6363
Mailing Address - Fax:954-981-3872
Practice Address - Street 1:1150 N 35TH AVE
Practice Address - Street 2:SUITE 170
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5424
Practice Address - Country:US
Practice Address - Phone:954-265-6363
Practice Address - Fax:954-981-3872
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6688103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL73057ZMedicare ID - Type Unspecified
FLP92271Medicare UPIN