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NPI 1497399224

NPI 1497399224 : JEAN ULRICK MEVOIT : MIAMI, FL

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General NPI Number Information
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    NPI Number           |    1497399224
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    Entity Type          |    Individual 
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    Provider Name        |    JEAN ULRICK MEVOIT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/05/2019
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    Last Update Date     |    07/01/2022
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Provider Practice Location Address
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    Address Line         |    13195 SW 134TH ST STE 201 
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33186-4585
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    Country              |    US
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    Telephone            |    786-206-6500
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    315 NW 138TH ST FL NA 
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    City                 |    NORTH MIAMI
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    State                |    FL
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    Zip                  |    33168-4013
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    Country              |    US
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    Telephone            |    917-702-4058
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    106S00000X
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    Taxonomy Name        |    Behavior Technician
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    License Number       |    
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    License Number State |    
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