MEDICARE: MS. ROBIN BONAN BARBERA L.C.S.W.

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	1041C0700X	Clinical Social Worker	SW6277	FL

General Provider Information

NPI Number	:	1245280585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ROBIN BONAN BARBERA L.C.S.W.

Provider Business Mailing Address
First Line	:	9460 EL CLAIR RANCH RD
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-3315
Country	:	US
Telephone Number	:	561-374-8903
Fax Number	:	561-735-4881

Provider Business Practice Location Address
First Line	:	1499 FOREST HILL BLVD
Second Line	:	SUITE 115
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-6050
Country	:	US
Telephone Number	:	561-374-8903
Fax Number	:	561-735-4881

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	07/09/2007

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