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1912135815
JORGE VIDAL
MELBOURNE, FL
NPI
1912135815
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Additional Taxonomies
171M00000X Case Manager/Care Coordinator
Enumeration Date
2009-06-30
Last Update Date
2015-10-23
Business Address
-- JORGE VIDAL
4450 W EAU GALLIE BLVD
MELBOURNE, FL 32934-7213
Phone number: 321-752-3100
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Mailing Address
-- JORGE VIDAL
4450 W EAU GALLIE BLVD 200
MELBOURNE, FL 32934-7213
Phone number: 321-722-5200
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