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Individual

JORGE CASTANEDA LOPEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3990 W FLAGLER ST, CORAL GABLES, FL 33134-1644
(305) 392-1143
(786) 332-2602
Mailing address
2441 NW 139TH ST, OPA LOCKA, FL 33054-4034
(305) 546-6136

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
FL

Other

Enumeration date
09/03/2024
Last updated
09/03/2024
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