MEDICARE: CINDY JILL NORTH LCSW., P.A.

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	SW3970	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992043657
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CINDY JILL NORTH LCSW., P.A.

Provider Business Mailing Address
First Line	:	1931 NW 150TH AVE STE 124
Second Line	:	PEMBROKE PINES
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33028-2873
Country	:	US
Telephone Number	:	954-322-1005
Fax Number	:

Provider Business Practice Location Address
First Line	:	1931 NW 150TH AVE STE 124
Second Line	:	PEMBROKE PINES
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33028-2873
Country	:	US
Telephone Number	:	954-322-1005
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. CINDY JILL NORTH
Credential	:	LCSW
Telephone Number	:	954-322-1005

Provider Enumeration Date	:	01/30/2013
Last Update Date	:	01/30/2013

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