MEDICARE: AS YOU UNFOLD INC

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

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Z062H	OTHER	FL	MEDICARE

General Provider Information

NPI Number	:	1841436797
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AS YOU UNFOLD INC

Provider Business Mailing Address
First Line	:	3511 W COMMERCIAL BLVD
Second Line	:	SUITE 305
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-3331
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3511 W COMMERCIAL BLVD
Second Line	:	SUITE 305
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-3331
Country	:	US
Telephone Number	:	954-558-0643
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RENEE SAYEGH
Credential	:	LCSW
Telephone Number	:	954-558-0643

Provider Enumeration Date	:	12/24/2008
Last Update Date	:	02/09/2009

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