Mr Michael J Mazucci-mambala, LCSW | |
510 Vonderburg Dr, Suite 301, Brandon, FL 33511-6072 | |
(813) 881-1000 | |
Not Available |
Full Name | Mr Michael J Mazucci-mambala |
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Gender | Male |
Speciality | Social Worker - Clinical |
Location | 510 Vonderburg Dr, Brandon, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1013556158 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | SW16647 (Florida) | Primary |
Entity Name | Mental Health Care Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1346224011 PECOS PAC ID: 2769469204 Enrollment ID: O20040702000312 |
Mailing Address | Practice Location Address |
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Mr Michael J Mazucci-mambala, LCSW 510 Vonderburg Dr, Suite 301, Brandon, FL 33511-6072 Ph: (813) 881-1000 | Mr Michael J Mazucci-mambala, LCSW 510 Vonderburg Dr, Suite 301, Brandon, FL 33511-6072 Ph: (813) 881-1000 |
Kelsey Paterson, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 126 Lithia Pinecrest Rd, Brandon, FL 33511 Phone: 813-689-8828 | |
Ms. Cynthia Anne Fletcher, L.C.S.W. Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 413 Ashford Dr, Brandon, FL 33511 Phone: 813-662-3441 | |
Michelle Ramirez, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 126 Lithia Pinecrest Rd, Brandon, FL 33511 Phone: 813-689-8828 | |
Karen Seales, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1419 Lake Lucerne Way, Brandon, FL 33511 Phone: 813-219-4551 | |
Brittany Wilson, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 126 Lithia Pinecrest Rd, Brandon, FL 33511 Phone: 813-689-8828 Fax: 813-689-8802 | |
Jessie A Shaw, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 109 N Oakwood Ave, Brandon, FL 33510 Phone: 813-819-8704 |