Individual
DR. JORGE LUIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
7000 NW 41ST ST, MIAMI, FL 33166-6817
(305) 562-6304
Mailing address
12281 SW 124TH TER, MIAMI, FL 33186-9054
(305) 562-6304
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY6677
FL
Other
Enumeration date
08/28/2023
Last updated
08/28/2023
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