MEDICARE: D&D PSYCH 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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	HCC5392	FL

General Provider Information

NPI Number	:	1982792438
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	D&D PSYCH INC

Provider Business Mailing Address
First Line	:	7392 NW 35TH TER
Second Line	:	SUITES 201/202
City	:	MIAMI
State	:	FL
Zip	:	33122-1271
Country	:	US
Telephone Number	:	305-597-9494
Fax Number	:	305-597-9495

Provider Business Practice Location Address
First Line	:	7392 NW 35TH TER
Second Line	:	SUITES 201/202
City	:	MIAMI
State	:	FL
Zip	:	33122-1271
Country	:	US
Telephone Number	:	305-597-9494
Fax Number	:	305-597-9495

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. GABRIELA MARIA RAURELL
Credential	:	LMHC
Telephone Number	:	786-271-2651

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	10/24/2007

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Directions to “D&D PSYCH INC ” Practice Location

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