Provider Demographics
NPI:1861794398
Name:HUBERMAN, MILAGROS (MS)
Entity type:Individual
Prefix:MRS
First Name:MILAGROS
Middle Name:
Last Name:HUBERMAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 601173
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-1173
Mailing Address - Country:US
Mailing Address - Phone:305-562-9585
Mailing Address - Fax:305-655-2169
Practice Address - Street 1:2999 NE 191ST ST
Practice Address - Street 2:SUITE 703
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-3123
Practice Address - Country:US
Practice Address - Phone:305-562-9585
Practice Address - Fax:305-655-2169
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-05
Last Update Date:2010-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH3927101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL762463800Medicaid