Basic Information
| Provider Information | |||||||||
| NPI: | 1053975136 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KNANASHOO | ||||||||
| FirstName: | MARGARET | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20110 SW 111TH AVE | ||||||||
| Address2: | |||||||||
| City: | CUTLER BAY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331891112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7862292985 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11440 N KENDALL DR STE 109 | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331761024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3059298705 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/24/2019 | ||||||||
| LastUpdateDate: | 08/12/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.