MEDICARE: IVETT BEVERLEY MCDONALD

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	2869	FL

General Provider Information

NPI Number	:	1275325797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IVETT BEVERLEY MCDONALD

Provider Business Mailing Address
First Line	:	4700 MADISON ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-7638
Country	:	US
Telephone Number	:	754-204-1507
Fax Number	:

Provider Business Practice Location Address
First Line	:	6114 SW 35TH CT
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33023-5164
Country	:	US
Telephone Number	:	754-204-1507
Fax Number	:	754-204-1507

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

Provider Enumeration Date	:	05/20/2025
Last Update Date	:	05/20/2025

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Directions to “ IVETT BEVERLEY MCDONALD ” Practice Location

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