MEDICARE: MARIA XIMENA DUARTE PSYD, 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	MH16649	FL
2	103TC0700X	Clinical Psychologist	PY11259	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	:	1316282817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA XIMENA DUARTE PSYD, LMHC

Provider Business Mailing Address
First Line	:	490 NE 141ST ST
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33161-3127
Country	:	US
Telephone Number	:	305-878-4842
Fax Number	:

Provider Business Practice Location Address
First Line	:	5901 NW 183RD ST STE 310
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-6008
Country	:	US
Telephone Number	:	786-418-9790
Fax Number	:

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

Provider Enumeration Date	:	12/10/2012
Last Update Date	:	09/09/2022

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