Organization Active NPI

David M Max PHD PA

  • Clinical Psychologist
  • Plantation, FL
National Provider Identifier
1053646018
Registry record updated Oct 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY3285 Issued in FL
Legal business name
DAVID M MAX PHD PA
Practice address
350 NW 70TH Ave
Plantation, FL 33317-2349
Phone
(954) 472-5933
Fax
(954) 587-7527
NPI assigned
Oct 8, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. David Martin Max, PHD
Title
President
Phone
(954) 472-5933

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PY3285 FL Primary

Addresses

Primary practice location

350 NW 70TH Ave
Plantation, FL 33317-2349

Mailing address

PO Box 15231
Plantation, FL 33318-5231
Phone (954) 472-5933

Other identifiers 2

IdentifierTypeStateIssuer
7685319-00MedicaidFL
75474OtherFLMEDICARE

National Provider Directory

National Provider Directory

Locations

350 NW 70th Ave
Plantation, FL 33317
Phone (954) 472-5933

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1254960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254960000000",
    "number": "1053646018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15231",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333185231",
            "telephone_number": "954-472-5933",
            "fax_number": "954-587-7527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 NW 70TH AVE",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172349",
            "telephone_number": "954-472-5933",
            "fax_number": "954-587-7527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID M MAX PHD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-08",
        "last_updated": "2009-10-08",
        "status": "A",
        "authorized_official_last_name": "MAX",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-472-5933",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY3285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7685319-00",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "75474",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.