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3810 Inverrary Blvd Ste 404a Lauderhill FL 33319-4381 | |
| (954) 892-4723 | |
| (954) 546-3444 |
| Full Name | |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 3810 Inverrary Blvd Ste 404a, Lauderhill, Florida |
| Authorized Official Name and Position | Clicile Dormeus (OWNER/OPERATOR) |
| Authorized Official Contact | 9548924723 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2170 Nw 85th Ave Sunrise FL 33322-3816 Ph: (954) 892-4723 | 3810 Inverrary Blvd Ste 404a Lauderhill FL 33319-4381 Ph: (954) 892-4723 |
| NPI Number | 1851812804 |
|---|---|
| Provider Enumeration Date | 06/29/2017 |
| Last Update Date | 07/09/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851812804 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW11310 (Florida) | Primary |
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