MEDICARE: DANIELE DEOLIVEIRA

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	SW21047	FL
2	1041C0700X	Clinical Social Worker	44SC06197900	NJ

General Provider Information

NPI Number	:	1699237222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELE DEOLIVEIRA

Provider Business Mailing Address
First Line	:	1533 SE 5TH ST
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33441-4927
Country	:	US
Telephone Number	:	646-739-3642
Fax Number	:

Provider Business Practice Location Address
First Line	:	162 OCEAN BLVD
Second Line	:
City	:	ATLANTIC HIGHLANDS
State	:	NJ
Zip	:	07716-1517
Country	:	US
Telephone Number	:	646-739-3642
Fax Number	:

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

Provider Enumeration Date	:	04/02/2019
Last Update Date	:	03/31/2023

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Directions to “ DANIELE DEOLIVEIRA ” Practice Location

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