MEDICARE: HEARTSPEAK LLC

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	SW 8225	FL

General Provider Information

NPI Number	:	1841588654
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEARTSPEAK LLC

Provider Business Mailing Address
First Line	:	1581 SW 55TH AVE
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33317-5322
Country	:	US
Telephone Number	:	954-257-6616
Fax Number	:	954-733-4483

Provider Business Practice Location Address
First Line	:	3511 W COMMERCIAL BLVD
Second Line	:	SUITE 305
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33309-3331
Country	:	US
Telephone Number	:	954-733-3394
Fax Number	:	954-733-4483

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	CHRISTINE R MURRAY
Credential	:	LCSW
Telephone Number	:	954-257-6616

Provider Enumeration Date	:	07/13/2011
Last Update Date	:	07/13/2011

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Directions to “HEARTSPEAK LLC ” Practice Location

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