Provider Demographics
NPI:1871508390
Name:PATRICIA FITZMAURICE LCSW PA
Entity type:Organization
Organization Name:PATRICIA FITZMAURICE LCSW PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FITZMAURICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-994-0310
Mailing Address - Street 1:950 PENINSULA CORPORATE CIRCLE
Mailing Address - Street 2:SUITE 1006
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487
Mailing Address - Country:US
Mailing Address - Phone:561-994-0310
Mailing Address - Fax:561-994-2045
Practice Address - Street 1:950 PENINSULA CORPORATE CIRCLE
Practice Address - Street 2:SUITE 1006
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487
Practice Address - Country:US
Practice Address - Phone:561-994-0310
Practice Address - Fax:561-994-2045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW4231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q0286Medicare PIN