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General NPI Number Information
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NPI Number | 1073210548
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Entity Type | Individual
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Provider Name | DANIELA FASKOWICZ
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Gender | Female
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Dates
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Enumeration Date | 02/14/2023
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Last Update Date | 02/14/2023
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Provider Practice Location Address
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Address Line | 2000 S DIXIE HWY STE 202
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City | MIAMI
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State | FL
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Zip | 33133-2469
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Country | US
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Telephone | 786-286-5965
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Fax |
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Provider Business Mailing Address
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Address Line | 8850 BYRON AVE
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City | SURFSIDE
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State | FL
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Zip | 33154-3435
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Country | US
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Telephone | 786-286-5965
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH18718
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License Number State | FL
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