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General NPI Number Information
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NPI Number | 1659735256
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Entity Type | Individual
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Provider Name | JODI MIRANDA CLE
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Gender | Female
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Dates
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Enumeration Date | 04/09/2016
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Last Update Date | 04/09/2016
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Provider Practice Location Address
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Address Line | 9275 SW 152ND ST SUITE 100
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City | PALMETTO BAY
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State | FL
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Zip | 33157-1701
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Country | US
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Telephone | 305-498-6722
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Fax |
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Provider Business Mailing Address
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Address Line | 329 RIDGEWOOD RD
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City | CORAL GABLES
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State | FL
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Zip | 33133-6615
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Country | US
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Telephone | 407-375-1672
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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 | 174H00000X
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Taxonomy Name | Health Educator
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License Number | 4-201604
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License Number State | FL
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