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NPI Code Detail

MEDICARE: EVELYN URICH CAP, ICADC

MEDICARE:   EVELYN  URICH  CAP, ICADC
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
1101YA0400XAddiction (Substance Use Disorder) CounselorCAP100133FL

General Provider Information

NPI Number : 1356072334
Entity Type Code : Individual
Provider Name (Legal Business Name) : EVELYN URICH CAP, ICADC
Provider Business Mailing Address
First Line : 2331 NE 53RD ST
Second Line :
City : FT LAUDERDALE
State : FL
Zip : 33308-3235
Country : US
Telephone Number : 954-491-9700
Fax Number : 954-491-9710
Provider Business Practice Location Address
First Line : 2331 NE 53RD ST
Second Line :
City : FT LAUDERDALE
State : FL
Zip : 33308-3235
Country : US
Telephone Number : 954-491-9700
Fax Number : 954-491-9710
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2022
Last Update Date : 06/21/2022

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Directions to “ EVELYN URICH CAP, ICADC” Practice Location

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