MEDICARE: MRS. MONICA JOANN BOSCH BATULE LCSW

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	18683	FL
2	101YM0800X	Mental Health Counselor	SW18683	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295400174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MONICA JOANN BOSCH BATULE LCSW

Provider Business Mailing Address
First Line	:	10930 SW 26TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-2302
Country	:	US
Telephone Number	:	305-322-9311
Fax Number	:

Provider Business Practice Location Address
First Line	:	3621 SW 107TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-3636
Country	:	US
Telephone Number	:	786-534-8366
Fax Number	:	786-534-7118

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

Provider Enumeration Date	:	08/12/2021
Last Update Date	:	08/17/2021

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