Provider Demographics
NPI:1477511954
Name:BAEZA-LINOWITZ, BERNADETTE (MS, LMHC)
Entity Type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:
Last Name:BAEZA-LINOWITZ
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 BAY DR APT 404
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141-5654
Mailing Address - Country:US
Mailing Address - Phone:305-582-3402
Mailing Address - Fax:305-864-8552
Practice Address - Street 1:900 BAY DR APT 404
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-5654
Practice Address - Country:US
Practice Address - Phone:305-582-3402
Practice Address - Fax:305-864-8552
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10820101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL751805600Medicaid