Individual provider Active NPI

Marilyn Bruce, LCSW

  • Clinical Social Worker
  • Coral Gables, FL
National Provider Identifier
1831270958
Registry record updated Apr 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW0003339 Issued in FL
Practice address
1450 Madruga Ave
Suite 306B
Coral Gables, FL 33146-3148
Phone
(305) 661-0440
Fax
(305) 668-2330
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW0003339 FL Primary

Addresses

Primary practice location

1450 Madruga Ave
Suite 306B
Coral Gables, FL 33146-3148

Mailing address

1450 Madruga Ave
Suite 306B
Coral Gables, FL 33146-3148
Phone (305) 661-0440

Other identifiers 1

IdentifierTypeStateIssuer
Z8579MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100910000979 FL Practitioner - Clinical Social Worker 0648395848 Practice locations: Coral Gables, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1390 S Dixie Hwy
Suite 1210
Coral Gables, FL 33146-2974
Phone (305) 338-5271

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334275200000",
    "number": "1831270958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 MADRUGA AVE",
            "address_2": "SUITE 306B",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331463148",
            "telephone_number": "305-661-0440",
            "fax_number": "305-668-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 MADRUGA AVE",
            "address_2": "SUITE 306B",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331463148",
            "telephone_number": "305-661-0440",
            "fax_number": "305-668-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCE",
        "first_name": "MARILYN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2012-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW0003339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z8579",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

Verify at the official NPI Registry.