Provider Demographics
NPI:1366583585
Name:TURKAT, IRA DANIEL (PHD)
Entity type:Individual
Prefix:DR
First Name:IRA
Middle Name:DANIEL
Last Name:TURKAT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1447
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34284-1447
Mailing Address - Country:US
Mailing Address - Phone:941-488-8093
Mailing Address - Fax:941-488-9407
Practice Address - Street 1:503 TAMIAMI TRL S
Practice Address - Street 2:#135
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-2927
Practice Address - Country:US
Practice Address - Phone:941-488-8093
Practice Address - Fax:941-488-9407
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 3856103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist