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1649454679
JORGE L PENA
MIAMI GARDENS, FL
NPI
1649454679
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
302F00000X Exclusive Provider Organization
(Licence: FL PY3600)
Enumeration Date
2007-12-27
Last Update Date
2007-12-27
Business Address
Dr. JORGE L PENA Clinical Psychologis
1825 NW 167TH ST SUITE #102
MIAMI GARDENS, FL 33056-4838
Phone number: 305-624-7450
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Mailing Address
Dr. JORGE L PENA Clinical Psychologis
9225 COLLINS AVENUE APT. #1411
SURFSIDE, FL 33154
Phone number: 305-442-8692
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