MEDICARE: MS. KAREN FERN GELLER LCSW

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	1041C0700X	Clinical Social Worker	SW 4613	FL

General Provider Information

NPI Number	:	1407127699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAREN FERN GELLER LCSW

Provider Business Mailing Address
First Line	:	1271 94TH ST
Second Line	:
City	:	BAY HARBOR ISLANDS
State	:	FL
Zip	:	33154-1901
Country	:	US
Telephone Number	:	305-609-3433
Fax Number	:

Provider Business Practice Location Address
First Line	:	1948 NE 123RD ST
Second Line	:	SUITE 107
City	:	NORTH MIAMI
State	:	FL
Zip	:	33181-2800
Country	:	US
Telephone Number	:	305-609-3433
Fax Number	:

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

Provider Enumeration Date	:	01/19/2012
Last Update Date	:	01/19/2012

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