MEDICARE: CADC CORP

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	MH7115	FL

General Provider Information

NPI Number	:	1437111903
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CADC CORP

Provider Business Mailing Address
First Line	:	8346 SW 8TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-4180
Country	:	US
Telephone Number	:	305-266-9620
Fax Number	:	305-266-9630

Provider Business Practice Location Address
First Line	:	8346 SW 8TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-4180
Country	:	US
Telephone Number	:	305-266-9620
Fax Number	:	305-266-9630

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LUIS IBANEZ
Credential	:
Telephone Number	:	305-266-9620

Provider Enumeration Date	:	04/03/2006
Last Update Date	:	10/16/2009

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Directions to “CADC CORP ” Practice Location

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