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NPI Code Detail

MEDICARE: BOARDPREP, LLC

MEDICARE: BOARDPREP, LLC
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
11041C0700XClinical Social WorkerSW5348FL

General Provider Information

NPI Number : 1487050597
Entity Type Code : Organization
Provider Name (Legal Business Name) : BOARDPREP, LLC
Provider Business Mailing Address
First Line : 2522 W KENNEDY BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33609-3306
Country : US
Telephone Number : 800-520-8475
Fax Number : 813-673-8000
Provider Business Practice Location Address
First Line : 2522 W KENNEDY BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33609-3306
Country : US
Telephone Number : 800-520-8475
Fax Number : 813-673-8000
Authorized Official
Title or Position : OWNER
Name : JOHN HARDEN
Credential : LCSW
Telephone Number : 800-520-8475
Provider Enumeration Date : 11/17/2014
Last Update Date : 07/20/2015

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Directions to “BOARDPREP, LLC ” Practice Location

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