Michael J Funk, PHD
Individual provider Active NPI Clinical Psychologist · Tavernier, FL
NPI 1407918253 · NPPES record last updated Oct 4, 2009
Key facts
- NPI
- 1407918253
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PY3550 (FL)
- Practice address
- 171 Hood Ave
Suite 10
Tavernier, FL 33070-2645 - Phone
- (305) 853-3284
- NPI assigned
- Dec 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY3550 | FL | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY3550 | FL | Yes |
Addresses
Primary practice location
171 Hood Ave
Suite 10
Tavernier, FL 33070-2645
Mailing address
PO Box 1074
Tavernier, FL 33070-1074
Phone (305) 393-3544
Other providers in Tavernier, FL
- Florida Keys Chiropractic and Welln
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- Florida Keys Pediatric and Adolescent Center, Inc
- Fun 4 Kids Therapy Inc
- Garrett Chiropractic & Wellness
- Patrice Gerard
- Allison Heather Glaze
- Deb N Goldberg
- Josue Emanuel Gomez
All providers in Tavernier, FL · Clinical Psychologist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 4, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.