MEDICARE: PENINA FLUG 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	SW 8501	FL

General Provider Information

NPI Number	:	1427174978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PENINA FLUG LCSW

Provider Business Mailing Address
First Line	:	3717 W BOYNTON BEACH BLVD
Second Line	:	SUITE 5
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33436-4540
Country	:	US
Telephone Number	:	561-738-2000
Fax Number	:	561-735-3688

Provider Business Practice Location Address
First Line	:	3717 W BOYNTON BEACH BLVD
Second Line	:	SUITE 5
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33436-4540
Country	:	US
Telephone Number	:	561-738-2000
Fax Number	:	561-735-3688

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

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	01/13/2012

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Directions to “ PENINA FLUG LCSW” Practice Location

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