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Individual

MR. JOSE RAUL VIDAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1030 SW 96TH AVE, MIAMI, FL 33174-2931
(772) 626-0295
Mailing address
1030 SW 96TH AVE, MIAMI, FL 33174-2931
(772) 626-0295

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
171M00000X
Case Manager/Care Coordinator

Other

Enumeration date
05/29/2013
Last updated
04/19/2019
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