Provider Demographics
NPI:1538782008
Name:ELIZABETH MILANO, LCSW PLLC
Entity type:Organization
Organization Name:ELIZABETH MILANO, LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:MILANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-345-0548
Mailing Address - Street 1:3901 NW 79TH AVE
Mailing Address - Street 2:SUITE 245 #1394
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33166
Mailing Address - Country:US
Mailing Address - Phone:904-345-0548
Mailing Address - Fax:
Practice Address - Street 1:579 TREE SIDE LN
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA
Practice Address - State:FL
Practice Address - Zip Code:32081-0027
Practice Address - Country:US
Practice Address - Phone:904-345-0548
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-19
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1144695321OtherPROVIDER NPI