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NPI Code Detail

MEDICARE: JORGE PIRELA

MEDICARE: JORGE PIRELA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1114431608
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORGE PIRELA
Provider Business Mailing Address
First Line : 2701 S PALM AIRE DR APT 102
Second Line :
City : POMPANO BEACH
State : FL
Zip : 33069-4222
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2701 S PALM AIRE DR APT 102
Second Line :
City : POMPANO BEACH
State : FL
Zip : 33069-4222
Country : US
Telephone Number : 954-803-2983
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2017
Last Update Date : 11/21/2017

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Directions to “ JORGE PIRELA ” Practice Location

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