MEDICARE: STANDISH I JERAULD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician		FL

General Provider Information

NPI Number	:	1154266138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STANDISH I JERAULD

Provider Business Mailing Address
First Line	:	1199 DOVE AVE
Second Line	:
City	:	MIAMI SPRINGS
State	:	FL
Zip	:	33166-3101
Country	:	US
Telephone Number	:	786-804-2421
Fax Number	:

Provider Business Practice Location Address
First Line	:	1199 DOVE AVE
Second Line	:
City	:	MIAMI SPRINGS
State	:	FL
Zip	:	33166-3101
Country	:	US
Telephone Number	:	786-804-2421
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2026
Last Update Date	:	04/23/2026

Similar Medicare Providers

1588558423 — ACCESS MEDICAL GROUP OF MIAMI MEDICARE, LLC
Practice Location Address:

701 NW 27TH AVE
MIAMI, FL
33125-3012

Practice Phone: 786-744-1900
Practice Fax: 305-760-4141

1790716660 — MR. DANIEL GREEN MD
Practice Location Address:

3101 SW 62 AVENUE
MIAMI, FL
33155

Practice Phone: 305-666-6511
Practice Fax: 305-662-8291

1548663180 — Y. P REHABILITATION CENTER CORP
Practice Location Address:

3101 NW 86TH ST
MIAMI, FL
33147-4061

Practice Phone: 786-763-7110
Practice Fax: 786-345-5930

1578968251 — AJK MED, LLC
Practice Location Address:

1504 BAY RD APT 3101
MIAMI BEACH, FL
33139-3280

Practice Phone: 646-623-1020
Practice Fax:

1699171785 — MD REHABILITATION CENTER INC
Practice Location Address:

3101 NW 86TH ST
MIAMI, FL
33147-4061

Practice Phone: 305-923-3874
Practice Fax: 305-504-2737

1184174641 — YUSNIER BORREGO ATC, LAT
Practice Location Address:

1120 SW 93RD AVE
MIAMI, FL
33174-3101

Practice Phone: 786-246-1634
Practice Fax:

Directions to “ STANDISH I JERAULD ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.