Healthcare Provider Details

I. General information

NPI: 1417372962
Provider Name (Legal Business Name): KAREN SUSANA ANDRADE MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2014
Last Update Date: 02/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11300 NE 2ND AVE
MIAMI SHORES FL
33161-6628
US

IV. Provider business mailing address

PO BOX 227472
MIAMI FL
33222-7472
US

V. Phone/Fax

Practice location:
  • Phone: 305-899-3900
  • Fax:
Mailing address:
  • Phone: 305-842-6073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: