Individual
JAVIER MOURIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
804 CO RD 466, LADY LAKE, FL 32159
(352) 978-1591
Mailing address
35107 RIVERSIDE CT, LEESBURG, FL 34788-3135
(352) 978-1591
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY9520
FL
Other
Enumeration date
10/17/2016
Last updated
10/17/2016
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