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1480 Sw 9th Ave Fort Lauderdale FL 33315-1375 | |
| (954) 764-5150 | |
| (954) 764-5143 |
| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1480 Sw 9th Ave, Fort Lauderdale, Florida |
| Authorized Official Name and Position | Mark Adler (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9547645150 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1480 Sw 9th Ave Fort Lauderdale FL 33315-1375 Ph: (954) 764-5150 | 1480 Sw 9th Ave Fort Lauderdale FL 33315-1375 Ph: (954) 764-5150 |
| NPI Number | 1780910968 |
|---|---|
| Provider Enumeration Date | 10/23/2009 |
| Last Update Date | 11/19/2009 |
| Medicare PECOS PAC ID | 9739358847 |
|---|---|
| Medicare Enrollment ID | O20110805000776 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780910968 | NPI | - | NPPES |
| Provider Name | Salvatore Miraglia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184680456 PECOS PAC ID: 8325234479 Enrollment ID: I20101201000460 |
| Provider Name | Alena K Yankie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942406426 PECOS PAC ID: 9830352954 Enrollment ID: I20120529000375 |
| Provider Name | Felice Dominic Fusca |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053721027 PECOS PAC ID: 4587988324 Enrollment ID: I20150127000116 |
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