Individual
MR. JUAN JESUS CECILIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MAA, CBHCMS
Contact information
Practice address
4175 W 20TH AVE, HIALEAH, FL 33012-5874
(305) 424-3111
Mailing address
4175 W 20TH AVE, HIALEAH, FL 33012-5874
(305) 424-3111
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
0102570
FL
Other
Enumeration date
12/06/2022
Last updated
12/07/2022
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