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General NPI Number Information
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NPI Number | 1043795081
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Entity Type | Individual
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Provider Name | NICOLE BUENO LMFT
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Gender | Female
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Dates
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Enumeration Date | 09/25/2018
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Last Update Date | 09/25/2018
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Provider Practice Location Address
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Address Line | 15490 NW 7TH AVE
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City | MIAMI
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State | FL
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Zip | 33169-6250
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Country | US
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Telephone | 786-308-8462
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Fax |
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Provider Business Mailing Address
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Address Line | 13155 IXORA CT APT 408
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City | NORTH MIAMI
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State | FL
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Zip | 33181-2330
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Country | US
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Telephone | 786-308-8462
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 3305
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License Number State | FL
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