MEDICARE: MARILYN B. CARCAS 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	101YM0800X	Mental Health Counselor	MH2496	FL

General Provider Information

NPI Number	:	1619242609
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARILYN B. CARCAS P.A.

Provider Business Mailing Address
First Line	:	11588 SW 91ST TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-1036
Country	:	US
Telephone Number	:	305-598-5337
Fax Number	:	305-595-0901

Provider Business Practice Location Address
First Line	:	7100 SW 99TH AVE
Second Line	:	SUITE 203
City	:	MIAMI
State	:	FL
Zip	:	33173-4667
Country	:	US
Telephone Number	:	305-598-5337
Fax Number	:	305-595-0901

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MARILYN B CARCAS
Credential	:	L.M.H.C.
Telephone Number	:	305-598-5337

Provider Enumeration Date	:	03/09/2012
Last Update Date	:	04/03/2012

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