MEDICARE: ADRIAN MIRABILE MSW, 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	26006	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	106SOOOOOX	OTHER		TRICARE

General Provider Information

NPI Number	:	1548721251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIAN MIRABILE MSW, LCSW

Provider Business Mailing Address
First Line	:	11958 XENIA LN
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32827-7185
Country	:	US
Telephone Number	:	706-905-1206
Fax Number	:

Provider Business Practice Location Address
First Line	:	11958 XENIA LN
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32827-7185
Country	:	US
Telephone Number	:	706-905-1206
Fax Number	:

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

Provider Enumeration Date	:	03/26/2019
Last Update Date	:	02/03/2026

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