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NPI Code Detail

MEDICARE: GENA KANOV LMHC

MEDICARE: GENA KANOV 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
1101YM0800XMental Health CounselorMH14556FL

General Provider Information

NPI Number : 1366915407
Entity Type Code : Individual
Provider Name (Legal Business Name) : GENA KANOV LMHC
Provider Business Mailing Address
First Line : 19425 SW 58TH MNR
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33332-3338
Country : US
Telephone Number : 954-252-5637
Fax Number :
Provider Business Practice Location Address
First Line : 19425 SW 58TH MNR
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33332-3338
Country : US
Telephone Number : 954-252-5637
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2019
Last Update Date : 01/10/2019

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Directions to “ GENA KANOV LMHC” Practice Location

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