Provider Demographics
NPI:1003564329
Name:FELIPE DRIGGS, JOSE ALEJANDRO
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:ALEJANDRO
Last Name:FELIPE DRIGGS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4670 W 13TH LN APT 507
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3247
Mailing Address - Country:US
Mailing Address - Phone:786-797-5280
Mailing Address - Fax:
Practice Address - Street 1:4670 W 13TH LN APT 507
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3247
Practice Address - Country:US
Practice Address - Phone:786-797-5280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-15
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician