| Michaelle Desruisseaux, | |
|
570 Koala Dr, Kissimmee, FL 34759-4210 | |
| (407) 285-5626 | |
| Not Available |
| Full Name | Michaelle Desruisseaux |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 570 Koala Dr, Kissimmee, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902110737 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LC200003082 (District Of Columbia) | Primary |
| 101YM0800X | Counselor - Mental Health | SW20097 (Florida) | Secondary |
| 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: O20210414000053 |
| Mailing Address | Practice Location Address |
|---|---|
| Michaelle Desruisseaux, 570 Koala Dr, Kissimmee, FL 34759-4210 Ph: (407) 285-5626 | Michaelle Desruisseaux, 570 Koala Dr, Kissimmee, FL 34759-4210 Ph: (407) 285-5626 |
Mrs. Brenda Santos-soto, L.C.S.W. Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 3105 Seaview Castle Dr, Kissimmee, FL 34746 Phone: 321-217-1231 | |
Mr. Eric Portalatin, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 120 Zacalo Way, Kissimmee, FL 34743 Phone: 407-910-8112 | |
Nicole Marie Castro, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4355 Summer Breeze Way, Kissimmee, FL 34744 Phone: 321-480-0890 | |
Mariel Mercado-rodriguez, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 318 Falling Water Dr, Kissimmee, FL 34759 Phone: 904-881-0486 | |
Amanda Melendez-williams, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3023 Sera Bella Way, Kissimmee, FL 34744 Phone: 321-362-0443 | |
Priscilla Mercado, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1320 N Main St, Kissimmee, FL 34744 Phone: 407-343-6006 Fax: 407-343-8289 | |
Reyna Astacio, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1012 Emmett St Ste A, Kissimmee, FL 34741 Phone: 407-382-9079 |