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NPI Code Detail

MEDICARE: JAIME ESTRADA TOME

MEDICARE:   JAIME  ESTRADA TOME
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
1104100000XSocial WorkerCBHCMS0102725FL

General Provider Information

NPI Number : 1871321422
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAIME ESTRADA TOME
Provider Business Mailing Address
First Line : 7110 W 3RD AVE
Second Line :
City : HIALEAH
State : FL
Zip : 33014-8303
Country : US
Telephone Number : 305-548-9398
Fax Number :
Provider Business Practice Location Address
First Line : 7110 W 3RD AVE
Second Line :
City : HIALEAH
State : FL
Zip : 33014-8303
Country : US
Telephone Number : 305-548-9398
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2024
Last Update Date : 07/24/2024

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Directions to “ JAIME ESTRADA TOME ” Practice Location

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