MEDICARE: ELI FELDMAN LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH9616	FL

General Provider Information

NPI Number	:	1043510969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELI FELDMAN LMHC

Provider Business Mailing Address
First Line	:	4465 N BAY RD
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2858
Country	:	US
Telephone Number	:	305-673-8753
Fax Number	:

Provider Business Practice Location Address
First Line	:	4465 N BAY RD
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2858
Country	:	US
Telephone Number	:	305-673-8753
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2010
Last Update Date	:	10/26/2010

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