MEDICARE: WINGS OF A BUTTERFLY PC

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	251B00000X	Case Management Agency	MH9102	FL

General Provider Information

NPI Number	:	1427448315
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WINGS OF A BUTTERFLY PC

Provider Business Mailing Address
First Line	:	14361 NW 87TH CT
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33018-8045
Country	:	US
Telephone Number	:	305-924-3230
Fax Number	:

Provider Business Practice Location Address
First Line	:	6001 NW 153RD ST STE 157
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33014-2447
Country	:	US
Telephone Number	:	305-924-3230
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. IDIANA MORALES
Credential	:	LMHC
Telephone Number	:	305-924-3230

Provider Enumeration Date	:	01/29/2015
Last Update Date	:	01/29/2015

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Directions to “WINGS OF A BUTTERFLY PC ” Practice Location

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