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General NPI Number Information
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NPI Number | 1801099155
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Entity Type | Organization
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Legal Business Name | DR ELENA COELLO-JEMMALI INC
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 06/24/2008
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Provider Practice Location Address
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Address Line | 14707 S DIXIE HWY #211
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City | PALMETTO BAY
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State | FL
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Zip | 33176-7948
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Country | US
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Telephone | 305-233-2010
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Fax | 305-233-2011
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Provider Business Mailing Address
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Address Line | 14707 S DIXIE HWY #211
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City | PALMETTO BAY
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State | FL
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Zip | 33176-7948
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Country | US
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Telephone | 305-233-2010
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Fax | 305-233-2011
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ELENA COELLO JEMMALI
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Credential | PSYD
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Telephone | 305-233-2010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PY04371
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License Number State | FL
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