Provider Demographics
NPI:1174861579
Name:NOZILE, MICHAEL JEAN
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JEAN
Last Name:NOZILE
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 1:1371 NE 114TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-6820
Mailing Address - Country:US
Mailing Address - Phone:305-776-6880
Mailing Address - Fax:
Practice Address - Street 1:1371 NE 114TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-6820
Practice Address - Country:US
Practice Address - Phone:305-776-6880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-21
Last Update Date:2013-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No251B00000XAgenciesCase Management