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General NPI Number Information
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NPI Number | 1477138410
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Entity Type | Individual
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Provider Name | DAVID MIZRAHI
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Gender | Male
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Dates
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Enumeration Date | 03/11/2021
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Last Update Date | 03/11/2021
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Provider Practice Location Address
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Address Line | 3405 NW 36TH STREET SUITE 112
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City | VIRGINIA GARDENS
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State | FL
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Zip | 33166
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Country | US
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Telephone | 305-871-3131
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Fax |
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Provider Business Mailing Address
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Address Line | 4050 NW 42ND AVE APT 215
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33319-4847
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Country | US
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Telephone | 786-237-1141
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | IMH19941
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License Number State | FL
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