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14905 Wedgefield Dr Apt 102 Delray Beach FL 33446-1382 | |
| (858) 282-6117 | |
| (951) 386-0182 |
| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 14905 Wedgefield Dr Apt 102, Delray Beach, Florida |
| Authorized Official Name and Position | Camille Brown (BILLER) |
| Authorized Official Contact | 5754059539 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
14905 Wedgefield Dr Apt 102 Delray Beach FL 33446-1382 Ph: (858) 282-6117 | 14905 Wedgefield Dr Apt 102 Delray Beach FL 33446-1382 Ph: (858) 282-6117 |
| NPI Number | 1366894651 |
|---|---|
| Provider Enumeration Date | 07/11/2016 |
| Last Update Date | 11/13/2024 |
| Certification Date | 11/13/2024 |
| Medicare PECOS PAC ID | 4981032331 |
|---|---|
| Medicare Enrollment ID | O20231107000761 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366894651 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 70535 (California) | Primary |
| Provider Name | Rafael M James |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467697151 PECOS PAC ID: 8527123603 Enrollment ID: I20231107001797 |
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