MEDICARE: DR. HOWARD CHUSID EDD

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	101YM0800X	Mental Health Counselor	IMH-6649	FL

General Provider Information

NPI Number	:	1659525616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOWARD CHUSID EDD

Provider Business Mailing Address
First Line	:	3001 W HALLANDALE BEACH BLVD
Second Line	:	SUITE 302
City	:	HALLANDALE
State	:	FL
Zip	:	33009-5155
Country	:	US
Telephone Number	:	954-455-0388
Fax Number	:	954-455-7588

Provider Business Practice Location Address
First Line	:	3001 W HALLANDALE BEACH BLVD
Second Line	:	SUITE 302
City	:	HALLANDALE
State	:	FL
Zip	:	33009-5155
Country	:	US
Telephone Number	:	954-455-0388
Fax Number	:	954-455-7588

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

Provider Enumeration Date	:	11/04/2008
Last Update Date	:	11/04/2008

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