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NPI Code Detail

MEDICARE: ANGELICA ARISTIZABAL LCSW

MEDICARE: ANGELICA ARISTIZABAL 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
1104100000XSocial WorkerISW12913FL
2101YM0800XMental Health CounselorSW18815FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245707603
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELICA ARISTIZABAL LCSW
Provider Business Mailing Address
First Line : 1506 WHITEHALL DR APT 105
Second Line :
City : DAVIE
State : FL
Zip : 33324-6611
Country : US
Telephone Number : 786-521-4712
Fax Number :
Provider Business Practice Location Address
First Line : 4175 W 20TH AVE
Second Line :
City : HIALEAH
State : FL
Zip : 33012-5874
Country : US
Telephone Number : 305-646-0112
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2018
Last Update Date : 09/30/2021

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Directions to “ ANGELICA ARISTIZABAL LCSW” Practice Location

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