Organization
JOSE J DERGAN P. A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LOURDES DERGAN (MANAGER)
(305) 599-1970
Entity
Organization
Contact information
Practice address
8249 NW 36TH ST STE 100, DORAL, FL 33166-6673
(305) 599-1970
(305) 599-1971
Mailing address
8249 NW 36TH ST STE 100, DORAL, FL 33166-6673
(305) 599-1970
(305) 599-1971
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY4206
FL
Other
Enumeration date
11/22/2010
Last updated
05/24/2011
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