Healthcare Provider Details

I. General information

NPI: 1659986271
Provider Name (Legal Business Name): CASSANDRA FIUME M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CASEY FIUME

II. Dates (important events)

Enumeration Date: 09/10/2020
Last Update Date: 09/10/2020
Certification Date: 09/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19336 SW 78TH AVE
CUTLER BAY FL
33157-8301
US

IV. Provider business mailing address

19336 SW 78TH AVE
CUTLER BAY FL
33157-8301
US

V. Phone/Fax

Practice location:
  • Phone: 786-306-2727
  • Fax:
Mailing address:
  • Phone: 786-306-2727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH19384
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: