MEDICARE: RAJALAKSHMI SUBRAHMANIAN LMHC

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	101YM0800X	Mental Health Counselor	MH5814	FL

General Provider Information

NPI Number	:	1306832555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAJALAKSHMI SUBRAHMANIAN LMHC

Provider Business Mailing Address
First Line	:	11851 NW 10TH PL
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-5047
Country	:	US
Telephone Number	:	954-413-1772
Fax Number	:	954-755-8255

Provider Business Practice Location Address
First Line	:	1750 N UNIVERSITY DR
Second Line	:	SUITE 201
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-8903
Country	:	US
Telephone Number	:	954-755-8247
Fax Number	:	954-755-8255

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

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	07/09/2007

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