Mirus, Carol S
Mirus, Carol S is an sole proprietor health care provider with primary practice located at 1103 Fortune Ave , Panama City FL 32401-1831. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Nursing Service Providers / Psychiatric/Mental Health. Behavioral Health & Social Service Providers / Marriage & Family Therapist is her primary health care specialty. Mirus, Carol S can be contacted via phone (850) 769-6188.Contact Information
Primary practice address
1103 Fortune Ave
Panama City FL 32401-1831
Phone: (850) 769-6188
Fax: (850) 769-1261
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | MT1140 | Florida |
| Nursing Service Providers / Psychiatric/Mental Health | 163WP0808X | RN56361-2 | Florida |
Profile Details
| NPI number | 1194889790 |
|---|---|
| LBN Legal business name | Mirus, Carol S |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 20th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194889790 | NPPES |
| Florida | Other | Z2167 | BLUE CROSS BLUE SHIELD |
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