| Corazan Aquino Ennis, | |
|
4100 Inverrary Dr, Lauderhill, FL 33319-4510 | |
| (616) 856-0636 | |
| Not Available |
| Full Name | Corazan Aquino Ennis |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 4100 Inverrary Dr, Lauderhill, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225715840 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW21721 (Florida) | Primary |
| Entity Name | Grow Healthcare Group Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20221213001514 |
| Mailing Address | Practice Location Address |
|---|---|
| Corazan Aquino Ennis, 4100 Inverrary Dr, Lauderhill, FL 33319-4510 Ph: (616) 856-0636 | Corazan Aquino Ennis, 4100 Inverrary Dr, Lauderhill, FL 33319-4510 Ph: (616) 856-0636 |
Jessica Oladumiye, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 6650 Landings Dr Apt 108, Lauderhill, FL 33319 Phone: 816-204-7632 | |
Nadette Noel, CLINICAL SOCIAL WORK Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 5131 N University Dr, Lauderhill, FL 33351 Phone: 954-268-9503 | |
Camille Burke, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3810 Inverrary Blvd Ste 404, Lauderhill, FL 33319 Phone: 754-551-1489 | |
Ms. Shantreirra Monroe, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 7860 W Commercial Blvd Stee 200 #634, Lauderhill, FL 33351 Phone: 561-601-9738 | |
Hershley Kalev Basile, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 3893 Nw 67th Way, Lauderhill, FL 33319 Phone: 954-773-6998 | |
Thomas G. Beley, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6800 W Commercial Blvd Ste 2, Lauderhill, FL 33319 Phone: 954-749-3444 |