MEDICARE: THAIS NAVARRETE LMFT

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	106H00000X	Marriage & Family Therapist	MT 2101	FL

General Provider Information

NPI Number	:	1265744114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THAIS NAVARRETE LMFT

Provider Business Mailing Address
First Line	:	11930 SW 121ST AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-5128
Country	:	US
Telephone Number	:	305-598-1000
Fax Number	:	305-271-7900

Provider Business Practice Location Address
First Line	:	11930 SW 121ST AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-5128
Country	:	US
Telephone Number	:	305-598-1000
Fax Number	:	305-271-7900

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

Provider Enumeration Date	:	07/08/2010
Last Update Date	:	07/08/2010

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