MEDICARE: JOSE M FELIPE

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
1	106S00000X	Behavior Technician		FL

General Provider Information

NPI Number	:	1477101210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE M FELIPE

Provider Business Mailing Address
First Line	:	4670 W 13TH LN APT 507
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-3247
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4670 W 13TH LN APT 507
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-3247
Country	:	US
Telephone Number	:	305-988-3591
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2019
Last Update Date	:	08/26/2019

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Directions to “ JOSE M FELIPE ” Practice Location

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