MEDICARE: MRS. DEBRA ELEANOR RODE LMHC

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	101YM0800X	Mental Health Counselor	MH3828	FL

General Provider Information

NPI Number	:	1275549057
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEBRA ELEANOR RODE LMHC

Provider Business Mailing Address
First Line	:	12555 ORANGE DR
Second Line	:	SUITE 267
City	:	DAVIE
State	:	FL
Zip	:	33330-4304
Country	:	US
Telephone Number	:	954-862-3644
Fax Number	:	954-472-3027

Provider Business Practice Location Address
First Line	:	12555 ORANGE DR
Second Line	:	SUITE 267
City	:	DAVIE
State	:	FL
Zip	:	33330-4304
Country	:	US
Telephone Number	:	954-862-3644
Fax Number	:	954-472-3027

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

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	03/09/2017

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