MEDICARE: ESTHER NICOLAS-PREDELUS

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	104100000X	Social Worker
2	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1396049359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ESTHER NICOLAS-PREDELUS

Provider Business Mailing Address
First Line	:	1401 S FEDERAL HWY
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33316-2619
Country	:	US
Telephone Number	:	954-712-5004
Fax Number	:

Provider Business Practice Location Address
First Line	:	15800 NE 4TH AVE
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-5164
Country	:	US
Telephone Number	:	954-901-0094
Fax Number	:

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

Provider Enumeration Date	:	01/06/2011
Last Update Date	:	12/21/2018

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