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Provider Information for 1053099820


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SHIRLEY CAROLINA DELMORAL LMHC


Sex: Female

NPI: 1053099820
Last Updated: 2023-07-10
Certification Date: 2023-07-10

Details

NameValue
NPI1053099820
Enumeration Date2023-07-10
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 9756 NW 127TH ST
HIALEAH GARDENS, FL 33018-7402
United States

Phone: 305-586-2235 | Fax:
 
Primary Practice Address 2225 N ANDREWS AVE
WILTON MANORS, FL 33311-3922
United States

Phone: 954-551-1989 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YM0800X - Counselor - Mental HealthFLMH14654