MEDICARE: ANXIETY & STRESS MANAGEMENT CENTER

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	103T00000X	Psychologist	SW1381	FL

General Provider Information

NPI Number	:	1336204783
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANXIETY & STRESS MANAGEMENT CENTER

Provider Business Mailing Address
First Line	:	9135 S.W. 125 AVE
Second Line	:	STE #P203
City	:	MIAMI
State	:	FL
Zip	:	33186
Country	:	US
Telephone Number	:	305-279-1715
Fax Number	:	305-279-1715

Provider Business Practice Location Address
First Line	:	8525 SW 92 STREET
Second Line	:	STE A3
City	:	MIAMI
State	:	FL
Zip	:	33156-7374
Country	:	US
Telephone Number	:	305-279-1715
Fax Number	:	305-279-8080

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. ARLENE O MILLER
Credential	:	LCSW
Telephone Number	:	305-279-1715

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	07/28/2010

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