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General NPI Number Information
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NPI Number | 1922457720
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Entity Type | Individual
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Provider Name | JOSE MAGIDE
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Gender | Male
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Dates
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Enumeration Date | 06/13/2016
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Last Update Date | 04/19/2019
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Provider Practice Location Address
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Address Line | 14648 SW 284TH ST UNIT 201
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City | HOMESTEAD
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State | FL
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Zip | 33033-1647
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Country | US
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Telephone | 786-655-3809
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Fax |
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Provider Business Mailing Address
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Address Line | 14648 SW 284TH ST UNIT 201
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City | HOMESTEAD
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State | FL
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Zip | 33033-1647
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Country | US
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Telephone | 786-655-3809
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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 | RBT-16-16155
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License Number State | FL
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