MEDICARE: RAPHA FAMILY SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	ISW 3390	FL

General Provider Information

NPI Number	:	1124277504
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAPHA FAMILY SERVICES

Provider Business Mailing Address
First Line	:	8325 NE 2ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33138-3815
Country	:	US
Telephone Number	:	786-267-1964
Fax Number	:

Provider Business Practice Location Address
First Line	:	8325 NE 2ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33138-3815
Country	:	US
Telephone Number	:	786-267-1964
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. ANNEZE BARTHELEMY BROWN
Credential	:	MSW
Telephone Number	:	786-267-1964

Provider Enumeration Date	:	09/10/2008
Last Update Date	:	05/04/2011

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