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General NPI Number Information
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NPI Number | 1235914987
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Entity Type | Individual
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Provider Name | MICHAEL KASDAGLIS
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Gender | Male
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Dates
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Enumeration Date | 08/30/2023
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Last Update Date | 08/30/2023
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Provider Practice Location Address
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Address Line | 8855 NW 17TH MNR
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-6061
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Country | US
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Telephone | 954-344-8352
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Fax | 964-287-1556
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Provider Business Mailing Address
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Address Line | 8855 NW 17TH MNR
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-6061
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Country | US
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Telephone | 954-344-8352
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Fax | 964-287-1556
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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 | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number | SW10575
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW10575
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License Number State | FL
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