MEDICARE: HILAH KRIEGER HAGBI

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	19701	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	19701	OTHER	FL	LCSW
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558002139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HILAH KRIEGER HAGBI

Provider Business Mailing Address
First Line	:	3414 FREEDOM DR
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-8415
Country	:	US
Telephone Number	:	786-617-5811
Fax Number	:

Provider Business Practice Location Address
First Line	:	17880 NE 13TH AVE
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-1308
Country	:	US
Telephone Number	:	786-617-5811
Fax Number	:

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

Provider Enumeration Date	:	04/06/2022
Last Update Date	:	04/06/2022

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