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NPI Code Detail

MEDICARE: NORELLA S. JUBIZ, PH.D., P.A.

MEDICARE: NORELLA S. JUBIZ, PH.D., P.A.
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
1103T00000XPsychologistPY9540FL

General Provider Information

NPI Number : 1265957807
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORELLA S. JUBIZ, PH.D., P.A.
Provider Business Mailing Address
First Line : 200 SE 15TH RD APT 3H
Second Line :
City : MIAMI
State : FL
Zip : 33129-1202
Country : US
Telephone Number : 786-378-1745
Fax Number :
Provider Business Practice Location Address
First Line : 2103 CORAL WAY STE 405
Second Line :
City : CORAL GABLES
State : FL
Zip : 33145-2630
Country : US
Telephone Number : 305-445-9554
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : NORELLA S. JUBIZ
Credential : PH.D.
Telephone Number : 786-378-1745
Provider Enumeration Date : 08/04/2017
Last Update Date : 08/04/2017

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