Shedrick John Boren, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW5359 Issued in FL

Practice address

2143 Fisher Island Dr
Miami, FL 33109-0059

Phone

(305) 860-5246

Fax

(305) 285-5042

NPI assigned

Sep 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Mercy Outpatient Services, Inc.

  • Long Term Care Hospital
  • Miami, FL
  • NPI 1093750473
  NPD (past) Authorized official

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720189913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2143 FISHER ISLAND DR",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331090059",
            "telephone_number": "305-860-5246",
            "fax_number": "305-285-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2143 FISHER ISLAND DR",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331090059",
            "telephone_number": "305-860-5246",
            "fax_number": "305-285-5042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOREN",
        "first_name": "SHEDRICK",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW5359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sergio Bordon
• Stephanie Michelle Bordonaba, OT
• Paola Andrea Bordoni, D.O.
• Angela Evette Boreland, RN
• Perla Borelli, PA-C
• Michal Borenstein
• Chester Borge, PA-C
• Kelenis Borge
• Brooke Borgert
• Jany Borges Alvarez

• All providers in Miami, FL
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.