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1881161180
JORGE LICEA
DORAL, FL
NPI
1881161180
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2018-10-25
Last Update Date
2018-12-29
Business Address
JORGE LICEA
9600 NW 25TH ST STE PH
DORAL, FL 33172
Phone number: 305-597-3861
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Mailing Address
JORGE LICEA
9600 NW 25TH ST STE PH
DORAL, FL 33172-1416
Phone number: 305-597-3861
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