Healthcare Provider Details

I. General information

NPI: 1326148875
Provider Name (Legal Business Name): GLENDER DE JESUS CURRAS BS,MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 09/02/2020
Certification Date: 09/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8842 NW 178TH LN
HIALEAH GARDENS FL
33018-6546
US

IV. Provider business mailing address

8842 NW 178TH LN
HIALEAH GARDENS FL
33018-6546
US

V. Phone/Fax

Practice location:
  • Phone: 786-487-3948
  • Fax:
Mailing address:
  • Phone: 786-487-3948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH 10549
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberMH10549
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: