MEDICARE: DENISLEYDIS DENIS

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	101Y00000X	Counselor
2	1041C0700X	Clinical Social Worker	SW14732	FL
3	103T00000X	Psychologist

Other Identifiers

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

General Provider Information

NPI Number	:	1821597014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISLEYDIS DENIS

Provider Business Mailing Address
First Line	:	1972 S CONGRESS AVE
Second Line	:
City	:	PALM SPRINGS
State	:	FL
Zip	:	33406-6674
Country	:	US
Telephone Number	:	786-525-6428
Fax Number	:

Provider Business Practice Location Address
First Line	:	1972 S CONGRESS AVE
Second Line	:
City	:	PALM SPRINGS
State	:	FL
Zip	:	33406-6674
Country	:	US
Telephone Number	:	786-525-6428
Fax Number	:

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

Provider Enumeration Date	:	02/02/2018
Last Update Date	:	07/17/2025

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Directions to “ DENISLEYDIS DENIS ” Practice Location

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