MEDICARE: MINORITY DEVELOPMENT & EMPOWERMENT, INC.

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	251B00000X	Case Management Agency
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1174873301
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINORITY DEVELOPMENT & EMPOWERMENT, INC.

Provider Business Mailing Address
First Line	:	5225 NW 33RD AVE
Second Line	:	BUILDING 5
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-6302
Country	:	US
Telephone Number	:	954-315-4530
Fax Number	:

Provider Business Practice Location Address
First Line	:	5225 NW 33RD AVE
Second Line	:	BUILDING 5
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-6302
Country	:	US
Telephone Number	:	954-315-4530
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	FRANCOIS LECONTE
Credential	:
Telephone Number	:	954-315-4530

Provider Enumeration Date	:	09/14/2012
Last Update Date	:	09/14/2012

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