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Provider Information for 1750423091


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Ms. JANET C CONDE


Sex: Female

NPI: 1750423091
Last Updated: 2020-08-04
Certification Date: 2020-08-04

Details

NameValue
NPI1750423091
Enumeration Date2007-02-13
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 7841 NW 192ND ST
HIALEAH, FL 33015-2757
United States

Phone: 305-308-0746 | Fax:
 
Primary Practice Address 4175 W 20TH AVE
HIALEAH, FL 33012-5874
United States

Phone: 305-825-0300 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDFL766342100
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YM0800X - Counselor - Mental HealthFLMH4521