Healthcare Provider Details
I. General information
NPI: 1912777947
Provider Name (Legal Business Name): DANIELA GELBSPAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/02/2024
Last Update Date: 01/02/2024
Certification Date: 01/02/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2801 NE 183RD ST APT 110W
AVENTURA FL
33160-2126
US
IV. Provider business mailing address
2801 NE 183RD ST APT 110W
AVENTURA FL
33160-2126
US
V. Phone/Fax
- Phone: 786-302-2846
- Fax:
- Phone: 786-302-2846
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | SW12035 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: