MEDICARE: MARICARMEN FRONTANEZ

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

General Provider Information

NPI Number	:	1164808366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARICARMEN FRONTANEZ

Provider Business Mailing Address
First Line	:	14404 VERANO DRIVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32837
Country	:	US
Telephone Number	:	787-677-8238
Fax Number	:

Provider Business Practice Location Address
First Line	:	14404 VERANO DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32837-4736
Country	:	US
Telephone Number	:	787-677-8238
Fax Number	:

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

Provider Enumeration Date	:	08/11/2015
Last Update Date	:	08/11/2015

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Directions to “ MARICARMEN FRONTANEZ ” Practice Location

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