MEDICARE: FRANCES PENA 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	104100000X	Social Worker	SW8150	FL
2	104100000X	Social Worker	R039029-1	NY

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	:	1518190875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANCES PENA LCSW

Provider Business Mailing Address
First Line	:	16095 SW 150TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33196-6559
Country	:	US
Telephone Number	:	305-975-4049
Fax Number	:	786-250-5532

Provider Business Practice Location Address
First Line	:	15160 SW 136TH ST UNIT 10
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33196-2664
Country	:	US
Telephone Number	:	305-975-4049
Fax Number	:

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

Provider Enumeration Date	:	09/02/2009
Last Update Date	:	02/20/2020

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Directions to “ FRANCES PENA LCSW” Practice Location

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