Provider Demographics
NPI:1013908110
Name:CENTER, LOUISE (MSW)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:
Last Name:CENTER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2627 NE 203RD ST
Mailing Address - Street 2:SUITE# 211
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1900
Mailing Address - Country:US
Mailing Address - Phone:305-932-0444
Mailing Address - Fax:305-932-6811
Practice Address - Street 1:2627 NE 203RD ST
Practice Address - Street 2:SUITE# 211
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33180-1900
Practice Address - Country:US
Practice Address - Phone:305-932-0444
Practice Address - Fax:305-932-6811
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-31
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW37761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ6780Medicare ID - Type Unspecified