Florida Psychological Center PLLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

FLORIDA PSYCHOLOGICAL CENTER PLLC

Practice address

100 Rialto PL Ste 718
Melbourne, FL 32901-3002

Phone

(321) 345-0579

Fax

(321) 360-7416

NPI assigned

Mar 21, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Glenn Matthew Sloman, PHD

Title

Executive Director

Phone

(321) 345-0579

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1553126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555027200000",
    "number": "1154881738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RIALTO PL STE 718",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013002",
            "telephone_number": "321-345-0579",
            "fax_number": "321-360-7416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RIALTO PL STE 718",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013002",
            "telephone_number": "321-345-0579",
            "fax_number": "321-360-7416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA PSYCHOLOGICAL CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-21",
        "last_updated": "2019-04-12",
        "status": "A",
        "authorized_official_last_name": "SLOMAN",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "321-345-0579",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2019; 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.