Provider Demographics
NPI:1447957436
Name:FIGUEROA, JAZMIN ENID
Entity type:Individual
Prefix:
First Name:JAZMIN
Middle Name:ENID
Last Name:FIGUEROA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18117 BISCAYNE BLVD STE 2163
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33160-2535
Mailing Address - Country:US
Mailing Address - Phone:786-749-8548
Mailing Address - Fax:
Practice Address - Street 1:12215 NW 17TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33167-2110
Practice Address - Country:US
Practice Address - Phone:786-863-6764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-10
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-252970106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty