Davonne D Breedlove, LCSW
Social Worker, Clinical in Miami, FL. Individual provider (NPI-1).
NPI number1164242517
StatusActive
Last updated in NPPESNov 10, 2024
Details
- NPI
- 1164242517
- Entity type
- Individual (NPI-1)
- Name
- Mr. Davonne D Breedlove
- Credential
- LCSW
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 11, 2024
- Certification date
- Nov 10, 2024
- Last updated
- Nov 10, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - CLINICAL SOCIAL WORKER
- Can order and refer
- Part B Yes · DME Yes · Home health No · Power mobility No · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | SW23518 | FL | Yes |
Practice location
66 W Flagler St Ste 900Miami, FL 33130-1807
Phone 786-416-0418
Mailing address
15111 Railroad DrMiami Gardens, FL 33054-2951
Phone 786-416-0418
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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