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NPI Code Detail

MEDICARE: MISS REBECCA MICHELLE FLEENOR LCSW

MEDICARE: MISS REBECCA MICHELLE FLEENOR 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
11041C0700XClinical Social WorkerSW16017FL

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 : 1255995262
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS REBECCA MICHELLE FLEENOR LCSW
Provider Business Mailing Address
First Line : 7821 N DALE MABRY HWY
Second Line :
City : TAMPA
State : FL
Zip : 33614-3275
Country : US
Telephone Number : 813-443-4827
Fax Number :
Provider Business Practice Location Address
First Line : 7821 N DALE MABRY HWY
Second Line :
City : TAMPA
State : FL
Zip : 33614-3275
Country : US
Telephone Number : 813-443-4827
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2019
Last Update Date : 04/24/2019

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