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NPI Code Detail

MEDICARE: MICHELE DISORBO LMHC

MEDICARE: MICHELE DISORBO LMHC
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
1101YM0800XMental Health CounselorMH4181FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710442942
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELE DISORBO LMHC
Provider Business Mailing Address
First Line : 1925 S PERIMETER RD STE 120
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33309-7123
Country : US
Telephone Number : 954-958-0988
Fax Number : 954-958-3527
Provider Business Practice Location Address
First Line : 1925 S PERIMETER RD STE 120
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33309-7123
Country : US
Telephone Number : 954-958-0988
Fax Number : 954-958-3527
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2019
Last Update Date : 02/01/2019

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