MEDICARE: AMARYLIS BARBOSA

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1912313834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMARYLIS BARBOSA

Provider Business Mailing Address
First Line	:	6100 BLUE LAGOON DR
Second Line	:	SUITE 400
City	:	MIAMI
State	:	FL
Zip	:	33126-2079
Country	:	US
Telephone Number	:	305-398-6100
Fax Number	:

Provider Business Practice Location Address
First Line	:	790 E BROWARD BLVD
Second Line	:	SUITE 300
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33301-2095
Country	:	US
Telephone Number	:	954-580-0770
Fax Number	:

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

Provider Enumeration Date	:	07/11/2014
Last Update Date	:	07/11/2014

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Directions to “ AMARYLIS BARBOSA ” Practice Location

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