MEDICARE: INSTITUTE OF CHILD & FAMILY HEALTH

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	251S00000X	Community/Behavioral Health Agency	8525	FL

General Provider Information

NPI Number	:	1407012347
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSTITUTE OF CHILD & FAMILY HEALTH

Provider Business Mailing Address
First Line	:	6912 W 30TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33018-5247
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6912 W 30TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33018-5247
Country	:	US
Telephone Number	:	305-820-1079
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	MRS. MARIA POU
Credential	:	LMHC
Telephone Number	:	786-253-9250

Provider Enumeration Date	:	07/30/2008
Last Update Date	:	07/30/2008

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