| Childrens Diagnostic & Treatment Center Inc | |
|
1401 S Federal Hwy Fort Lauderdale FL 33316-2619 | |
| (954) 728-8080 | |
| (954) 779-1957 |
| Full Name | Childrens Diagnostic & Treatment Center Inc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1401 S Federal Hwy, Fort Lauderdale, Florida |
| Authorized Official Name and Position | Ana Calderon-randazzo (ADMINSTRATOR) |
| Authorized Official Contact | 9547281060 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Childrens Diagnostic & Treatment Center Inc 1700 Nw 49th St Ste 125 Fort Lauderdale FL 33309-3750 Ph: (954) 728-8080 | Childrens Diagnostic & Treatment Center Inc 1401 S Federal Hwy Fort Lauderdale FL 33316-2619 Ph: (954) 728-8080 |
| NPI Number | 1699907832 |
|---|---|
| Provider Enumeration Date | 08/21/2009 |
| Last Update Date | 04/01/2024 |
| Certification Date | 04/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699907832 | NPI | - | NPPES |
| 34478 | Other | FL | BCBS |
| 006458400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (Florida) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
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