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NPI Code Detail

MEDICARE: LUBA BOZANICH

MEDICARE:   LUBA  BOZANICH
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
11041C0700XClinical Social WorkerSW3601FL

General Provider Information

NPI Number : 1558477364
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUBA BOZANICH
Provider Business Mailing Address
First Line : 915 MIDDLE RIVER DR
Second Line : #307
City : FT LAUDERDALE
State : FL
Zip : 33304-3544
Country : US
Telephone Number : 954-701-5822
Fax Number :
Provider Business Practice Location Address
First Line : 915 MIDDLE RIVER DR
Second Line : #307
City : FT LAUDERDALE
State : FL
Zip : 33304-3544
Country : US
Telephone Number : 954-701-5822
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2006
Last Update Date : 09/03/2013

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Directions to “ LUBA BOZANICH ” Practice Location

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