Healthcare Provider Details

I. General information

NPI: 1841110962
Provider Name (Legal Business Name): MARILYN ALBAUM
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2026
Last Update Date: 07/18/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 MYSTIC POINTE DR APT 705
AVENTURA FL
33180-2558
US

IV. Provider business mailing address

3600 MYSTIC POINTE DR APT 705
AVENTURA FL
33180-2558
US

V. Phone/Fax

Practice location:
  • Phone: 786-317-7288
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW18015
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: