MEDICARE: DADE COUNSELING CENTER, P.A.

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	174400000X	Specialist	MH2508	FL

General Provider Information

NPI Number	:	1275541971
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DADE COUNSELING CENTER, P.A.

Provider Business Mailing Address
First Line	:	2122 LUDLAM RD
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-1838
Country	:	US
Telephone Number	:
Fax Number	:	305-266-3702

Provider Business Practice Location Address
First Line	:	2122 LUDLAM RD
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-1838
Country	:	US
Telephone Number	:	305-266-3200
Fax Number	:	305-266-3702

Authorized Official
Title or Position	:	OWNER
Name	:	PATRICIA CALDERON
Credential	:
Telephone Number	:	305-266-3200

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	08/22/2020

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