MEDICARE: LINDA OXENBERG LCSW, P.A.

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	SW2961	FL

General Provider Information

NPI Number	:	1477807857
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINDA OXENBERG LCSW, P.A.

Provider Business Mailing Address
First Line	:	PO BOX 547247
Second Line	:
City	:	SURFSIDE
State	:	FL
Zip	:	33154-7247
Country	:	US
Telephone Number	:	305-861-0500
Fax Number	:

Provider Business Practice Location Address
First Line	:	9550 BAY HARBOR TER
Second Line	:
City	:	BAY HARBOR ISLANDS
State	:	FL
Zip	:	33154-2024
Country	:	US
Telephone Number	:	305-861-0500
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LINDA OXENBERG
Credential	:	LCSW
Telephone Number	:	305-861-0500

Provider Enumeration Date	:	11/06/2012
Last Update Date	:	11/06/2012

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