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JEAN MOISE DERIVOIS

>> Case Manager/Care Coordinator >> Other Service Providers

Registrant NPI Number: 1184260887

Individual Registrant:
 JEAN MOISE DERIVOIS 
Gender: M
Sole Proprietor

Location and contact information for practice:
2780 SW 37TH AVE  COCONUT GROVE, FL 33133-2740 US
Tel: 305-640-0112  Fax: --

Contact information for business:
10541 SW 224TH TER  CUTLER BAY, FL 33190-1391 US
Tel: 786-223-3163  Fax: --

Registration Information:
NPI: 1184260887
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y171M00000XOther Service Providers
Case Manager/Care Coordinator

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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