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Individual

DR. JAIME RAUL PICANOL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
9370 SUNSET DR STE A213, MIAMI, FL 33173-5452
(305) 331-6011
(305) 242-5526
Mailing address
4128 NE 30TH ST, HOMESTEAD, FL 33033-5178
(305) 331-6011
(305) 242-5526

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY9057
FL
103TF0200X
Forensic Psychologist
PY9057
FL

Other

Enumeration date
05/06/2019
Last updated
05/06/2019
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