MEDICARE: SAYRA CANDICE BESNER 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	SW23215	FL

General Provider Information

NPI Number	:	1578298394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAYRA CANDICE BESNER LCSW

Provider Business Mailing Address
First Line	:	7900 HARBOR ISLAND DR APT 821
Second Line	:
City	:	NORTH BAY VILLAGE
State	:	FL
Zip	:	33141-4289
Country	:	US
Telephone Number	:	786-626-0661
Fax Number	:

Provider Business Practice Location Address
First Line	:	7900 HARBOR ISLAND DR APT 821
Second Line	:
City	:	NORTH BAY VILLAGE
State	:	FL
Zip	:	33141-4289
Country	:	US
Telephone Number	:	786-626-0661
Fax Number	:

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

Provider Enumeration Date	:	07/18/2022
Last Update Date	:	07/12/2024

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