MEDICARE: MRS. AIMEE RUNHAAR-TAYLOR 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	SW 6490	FL

General Provider Information

NPI Number	:	1659761963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AIMEE RUNHAAR-TAYLOR LCSW

Provider Business Mailing Address
First Line	:	9070 KIMBERLY BLVD
Second Line	:	STE 50
City	:	BOCA RATON
State	:	FL
Zip	:	33434-2861
Country	:	US
Telephone Number	:	561-852-0910
Fax Number	:	561-852-0960

Provider Business Practice Location Address
First Line	:	2717 E OAKLAND PARK BLVD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33306-1664
Country	:	US
Telephone Number	:	954-288-0131
Fax Number	:

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

Provider Enumeration Date	:	01/26/2015
Last Update Date	:	11/10/2016

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