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NPI Code Detail

MEDICARE: DISCOVER YOURSELF INCORPORATED

MEDICARE: DISCOVER YOURSELF INCORPORATED
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
1251S00000XCommunity/Behavioral Health AgencySW 10044FL

General Provider Information

NPI Number : 1942519020
Entity Type Code : Organization
Provider Name (Legal Business Name) : DISCOVER YOURSELF INCORPORATED
Provider Business Mailing Address
First Line : 511 SE 5TH AVE
Second Line : APT. 1812
City : FT LAUDERDALE
State : FL
Zip : 33301-2984
Country : US
Telephone Number : 786-683-4331
Fax Number :
Provider Business Practice Location Address
First Line : 511 SE 5TH AVE
Second Line : APT. 1812
City : FT LAUDERDALE
State : FL
Zip : 33301-2984
Country : US
Telephone Number : 786-683-4331
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : KIRSTEN LYNGVED SHEA
Credential : LCSW
Telephone Number : 786-683-4331
Provider Enumeration Date : 10/06/2010
Last Update Date : 02/13/2012

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Directions to “DISCOVER YOURSELF INCORPORATED ” Practice Location

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