Mir Land Eugene, MA, MS

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

4469 NW 167TH St
Opa Locka, FL 33055-4311

Phone

(305) 621-1455

Fax

(305) 621-5508

NPI assigned

Jun 16, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts, Master of Science

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1417991555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11031 NE 6TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331617182",
            "telephone_number": "305-398-6100",
            "fax_number": "305-757-4465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4469 NW 167TH ST",
            "city": "OPA LOCKA",
            "state": "FL",
            "postal_code": "330554311",
            "telephone_number": "305-621-1455",
            "fax_number": "305-621-5508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUGENE",
        "first_name": "MIR LAND",
        "credential": "MA, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "764792100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Opa Locka, FL
• Providers in Opa Locka, FL by specialty
• Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.