MEDICARE: CLAIRE GREENFEST

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	103TB0200X	Cognitive & Behavioral Psychologist	G651-113-90-844-0	FL

General Provider Information

NPI Number	:	1972052595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAIRE GREENFEST

Provider Business Mailing Address
First Line	:	3711 SW 160TH AVE.
Second Line	:	APT. 107
City	:	MIRAMAR
State	:	FL
Zip	:	33027
Country	:	US
Telephone Number	:	305-505-6275
Fax Number	:

Provider Business Practice Location Address
First Line	:	3711 SW 160TH AVE
Second Line	:	APT. 107
City	:	MIRAMAR
State	:	FL
Zip	:	33027-4658
Country	:	US
Telephone Number	:	305-505-6275
Fax Number	:

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

Provider Enumeration Date	:	09/23/2016
Last Update Date	:	09/23/2016

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