Individual provider Active NPI

Deborah Bruno, LCSW

  • Clinical Psychologist
  • Aventura, FL
National Provider Identifier
1467552174
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
SW6832 Issued in FL
Practice address
2627 NE 203Rd St
Suite 211
Aventura, FL 33180-1900
Phone
(305) 905-7177
NPI assigned
Sep 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X SW6832 FL Primary

Addresses

Primary practice location

2627 NE 203Rd St
Suite 211
Aventura, FL 33180-1900

Mailing address

3400 NE 192ND St
PH LP10
Aventura, FL 33180-2462
Phone (305) 905-7177

Other identifiers 1

IdentifierTypeStateIssuer
Z011LOtherFLBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050511000072 FL Practitioner - Clinical Social Worker 2466492350 Reassigns benefits to 2 organizations
I20240321000020 NJ Practitioner - Clinical Social Worker 2466492350 Practice locations: Mays Landing, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2627 NE 203Rd St
Suite 214
Aventura, FL 33180-1946
Phone (305) 905-7177

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mindbuilders Inc. Clinical CurrentSince Jan 15, 2010 Accepting new patients
Boca Raton Psychiatry, LLC CurrentSince Sep 1, 2021 Accepting new patients
Caregivers Solutions, Inc. Clinical Past Accepting new patients

Locations

9980 Central Park Blvd N
Ste 210
Boca Raton, FL 33428
Phone (561) 342-8822

15300 S Jog Rd
Ste 203
Delray Beach, FL 33446
Phone (561) 638-8385

2627 NE 203rd St
Ste 214
Miami, FL 33180
Phone (305) 542-0300

2627 NE 203rd St
Ste 211
Miami, FL 33180
Phone (305) 905-7177

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467552174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 NE 192ND ST",
            "address_2": "PH LP10",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331802462",
            "telephone_number": "305-905-7177",
            "fax_number": "305-792-0217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2627 NE 203RD ST",
            "address_2": "SUITE 211",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801900",
            "telephone_number": "305-905-7177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNO",
        "first_name": "DEBORAH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "SW6832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Z011L",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aventura, FL

Sources for this page

Verify at the official NPI Registry.