MEDICARE: MR. JAMES HUYSMAN LCSW

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	1041C0700X	Clinical Social Worker	SW3227	FL

General Provider Information

NPI Number	:	1235380882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES HUYSMAN LCSW

Provider Business Mailing Address
First Line	:	3050 BISCAYNE BLVD
Second Line	:	SUITE 605
City	:	MIAMI
State	:	FL
Zip	:	33137-4158
Country	:	US
Telephone Number	:	305-571-9996
Fax Number	:	305-571-9506

Provider Business Practice Location Address
First Line	:	3050 BISCAYNE BLVD
Second Line	:	SUITE 605
City	:	MIAMI
State	:	FL
Zip	:	33137-4158
Country	:	US
Telephone Number	:	305-571-9996
Fax Number	:	305-571-9506

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

Provider Enumeration Date	:	10/01/2008
Last Update Date	:	10/01/2008

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