Healthcare Provider Details

I. General information

NPI: 1093130049
Provider Name (Legal Business Name): JILL KUBER PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2014
Last Update Date: 09/27/2024
Certification Date: 09/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 NE 183RD ST UNIT 303
AVENTURA FL
33160-4477
US

IV. Provider business mailing address

3301 NE 183RD ST UNIT 303
AVENTURA FL
33160-4477
US

V. Phone/Fax

Practice location:
  • Phone: 305-785-7858
  • Fax:
Mailing address:
  • Phone: 305-785-7858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY6188
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberPY6188
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: