MEDICARE: VANINA ARENOVICH L.M.F.T.

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	106H00000X	Marriage & Family Therapist	MT 2279	FL

General Provider Information

NPI Number	:	1275850356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANINA ARENOVICH L.M.F.T.

Provider Business Mailing Address
First Line	:	1415 YELLOWHEART WAY
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33019-4859
Country	:	US
Telephone Number	:	305-318-1934
Fax Number	:

Provider Business Practice Location Address
First Line	:	1975 E SUNRISE BLVD
Second Line	:	533
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33304-1433
Country	:	US
Telephone Number	:	954-232-7092
Fax Number	:	954-208-3400

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

Provider Enumeration Date	:	04/28/2010
Last Update Date	:	04/28/2010

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