Active NPI
Manoucheka S Dezine
- Social Worker
- Miami, FL
National Provider Identifier
1710567375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- ISW8528
- Practice address
- 111 NW 183Rd St Ste 404
Miami, FL 33169-4619 - Phone
- (305) 735-1340
- NPI assigned
- Apr 8, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | ISW8528 | FL | Primary |
Addresses
Primary practice location
111 NW 183Rd St Ste 404
Miami, FL 33169-4619
Mailing address
3015 NW 30TH Way
Lauderdale Lakes, FL 33311-8497
Phone (305) 735-1340
Other practice location 1
5114 Okeechobee Blvd Ste 112
West Palm Beach, FL 33417-4575
Phone (561) 921-7149
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ISW8528 | FL | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621555200000",
"number": "1710567375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3015 NW 30TH WAY",
"city": "LAUDERDALE LAKES",
"state": "FL",
"postal_code": "333118497",
"telephone_number": "305-735-1340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 NW 183RD ST STE 404",
"city": "MIAMI",
"state": "FL",
"postal_code": "331694619",
"telephone_number": "305-735-1340"
}
],
"practiceLocations": [
{
"address_1": "5114 Okeechobee Blvd Ste 112",
"address_purpose": "LOCATION",
"city": "West Palm Beach",
"state": "FL",
"postal_code": "334174575",
"country_code": "US",
"telephone_number": "561-921-7149",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DEZINE",
"first_name": "MANOUCHEKA",
"middle_name": "S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-08",
"last_updated": "2021-05-21",
"certification_date": "2021-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "FL",
"license": "ISW8528",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.