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NPI Code Detail

MEDICARE: FLORIDA PERSONAL GROWTH CENTER, INC

MEDICARE: FLORIDA PERSONAL GROWTH CENTER, INC
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
1101YM0800XMental Health CounselorMH 2998FL

General Provider Information

NPI Number : 1275699621
Entity Type Code : Organization
Provider Name (Legal Business Name) : FLORIDA PERSONAL GROWTH CENTER, INC
Provider Business Mailing Address
First Line : 3511 W COMMERCIAL BLVD
Second Line : SUITE 305
City : FORT LAUDERDALE
State : FL
Zip : 33309-3331
Country : US
Telephone Number : 954-733-3394
Fax Number : 954-733-4483
Provider Business Practice Location Address
First Line : 3511 W COMMERCIAL BLVD
Second Line : SUITE 305
City : FORT LAUDERDALE
State : FL
Zip : 33309-3331
Country : US
Telephone Number : 954-733-3394
Fax Number : 954-733-4483
Authorized Official
Title or Position : OWNER
Name : MS. CAREN J GLASSMAN
Credential :
Telephone Number : 954-733-3394
Provider Enumeration Date : 12/29/2006
Last Update Date : 08/22/2020

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Directions to “FLORIDA PERSONAL GROWTH CENTER, INC ” Practice Location

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