=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003934522
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANA C. FIRMAT L.C.S.W
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/26/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 101 MAJORCA AVE
-----------------------------------------------------
City | CORAL GABLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33134-4508
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-827-2620
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8931 NW 194TH TER
-----------------------------------------------------
City | HIALEAH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33018-6225
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-827-2620
-----------------------------------------------------
Fax | 305-829-6069
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | SW2192
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------