Provider Demographics
NPI:1366032971
Name:DUGARTE, MIRIAM GENOVEVA (CBHCM)
Entity Type:Individual
Prefix:MRS
First Name:MIRIAM
Middle Name:GENOVEVA
Last Name:DUGARTE
Suffix:
Gender:F
Credentials:CBHCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4575 SW 112TH TER UNIT 102
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-7924
Mailing Address - Country:US
Mailing Address - Phone:305-283-0255
Mailing Address - Fax:
Practice Address - Street 1:4575 SW 112TH TER UNIT 102
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-7924
Practice Address - Country:US
Practice Address - Phone:305-283-0255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-19
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty