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JEAN MOISE DERIVOIS
>> Case Manager/Care Coordinator >> Other Service ProvidersRegistrant NPI Number: 1184260887
Individual Registrant: JEAN MOISE DERIVOIS
Gender: M
Sole Proprietor
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: --
Tel: 305-640-0112 Fax: --
Contact information for business:
10541 SW 224TH TER CUTLER BAY, FL 33190-1391 US
Tel: 786-223-3163 Fax: --
Tel: 786-223-3163 Fax: --
Registration Information:
NPI: 1184260887
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 171M00000X | Other Service Providers Case Manager/Care Coordinator |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
