MEDICARE: DAGMAR MAE MIRABAL LCSW-QS

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	SW13260	FL

General Provider Information

NPI Number	:	1700259652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAGMAR MAE MIRABAL LCSW-QS

Provider Business Mailing Address
First Line	:	8516 CUTLER CT
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33189-2511
Country	:	US
Telephone Number	:	305-331-2239
Fax Number	:

Provider Business Practice Location Address
First Line	:	8516 CUTLER CT
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33189-2511
Country	:	US
Telephone Number	:	305-331-2239
Fax Number	:

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

Provider Enumeration Date	:	11/01/2015
Last Update Date	:	01/15/2026

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