Paul J Miske PH D LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY 6267 Issued in FL

Legal business name

PAUL J MISKE PH D LLC

Practice address

916 El Dorado Pkwy W
Cape Coral, FL 33914-7251

Phone

(239) 242-0588

Fax

(239) 242-9945

NPI assigned

Jan 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Paul J Miske, PH D

Title

Owner

Phone

(239) 242-0588

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192406400000",
    "number": "1275689762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 SE 28TH ST",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339043284",
            "telephone_number": "239-242-0588",
            "fax_number": "239-242-9945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 EL DORADO PKWY W",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339147251",
            "telephone_number": "239-242-0588",
            "fax_number": "239-242-9945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL J MISKE PH D LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-10-15",
        "status": "A",
        "authorized_official_last_name": "MISKE",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-242-0588",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 6267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBC OF FL PROVIDER NUMBE",
            "identifier": "54611",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Cape Coral, FL
• Providers in Cape Coral, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; 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.