Healthcare Provider Details

I. General information

NPI: 1447684428
Provider Name (Legal Business Name): JOSE A ORELLANA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2013
Last Update Date: 08/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2461 W 76TH ST 102
HIALEAH FL
33016-5671
US

IV. Provider business mailing address

2461 W 76TH ST 102
HIALEAH FL
33016-5671
US

V. Phone/Fax

Practice location:
  • Phone: 305-248-3488
  • Fax: 305-248-6558
Mailing address:
  • Phone: 305-248-3488
  • Fax: 305-248-6558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: