Provider Demographics
NPI:1114109915
Name:SENICES, JULISSA (PH D)
Entity Type:Individual
Prefix:DR
First Name:JULISSA
Middle Name:
Last Name:SENICES
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 MADRUGA AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-3148
Mailing Address - Country:US
Mailing Address - Phone:305-310-6386
Mailing Address - Fax:
Practice Address - Street 1:1450 MADRUGA AVENUE
Practice Address - Street 2:SUITE 300
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-3062
Practice Address - Country:US
Practice Address - Phone:305-310-6386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-04
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7590103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist