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General NPI Number Information
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NPI Number | 1659188498
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Entity Type | Individual
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Provider Name | MR. LUBERT SIMILIEN
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Gender | Male
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 1050 NW 112TH TER
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City | MIAMI
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State | FL
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Zip | 33168-6150
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Country | US
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Telephone | 786-384-6161
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Fax |
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Provider Business Mailing Address
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Address Line | 1050 NW 112TH TER
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City | MIAMI
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State | FL
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Zip | 33168-6150
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Country | US
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Telephone | 786-384-6161
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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 | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | S545-520-79-372-0
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License Number State |
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