Oren David Wunderman, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY3862 Issued in FL

Practice address

7600 Southwest 57TH Ave.
Suite 222
South Miami, FL 33143

Phone

(786) 236-0573

Fax

(305) 385-7164

NPI assigned

Apr 23, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649498536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 SOUTHWEST 57TH. AVE.",
            "address_2": "SUITE 222",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "33143",
            "telephone_number": "786-236-0573",
            "fax_number": "305-385-6174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 SOUTHWEST 57TH AVE.",
            "address_2": "SUITE 222",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "33143",
            "telephone_number": "786-236-0573",
            "fax_number": "305-385-7164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUNDERMAN",
        "first_name": "OREN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY3862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGIST",
            "identifier": "PY3862",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARRIAGE & FAMILY THERAPI",
            "identifier": "MT716",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MENTAL HEALTH COUNSELOR",
            "identifier": "MH255",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in South Miami, FL
• Providers in South Miami, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.