MEDICARE: MS. ROXANA YASMIN CARMENATE LCSW-QS, MSW

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	SW11438	FL
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1861829954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ROXANA YASMIN CARMENATE LCSW-QS, MSW

Provider Business Mailing Address
First Line	:	1831 NW 104TH AVE
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33026-2354
Country	:	US
Telephone Number	:	954-200-2545
Fax Number	:

Provider Business Practice Location Address
First Line	:	9734 W SAMPLE RD # 200
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-4004
Country	:	US
Telephone Number	:	954-903-1323
Fax Number	:	954-431-6993

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

Provider Enumeration Date	:	10/03/2013
Last Update Date	:	07/21/2023

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