Provider Demographics
NPI:1326558586
Name:CASPIO VIJANDE, ERNESTO J
Entity Type:Individual
Prefix:
First Name:ERNESTO
Middle Name:J
Last Name:CASPIO VIJANDE
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 1:4916 SW 142ND PLACE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-5024
Mailing Address - Country:US
Mailing Address - Phone:786-314-3516
Mailing Address - Fax:
Practice Address - Street 1:3412 W .84 ST
Practice Address - Street 2:UNIT E 106
Practice Address - City:MIAMI HIALIAH
Practice Address - State:FL
Practice Address - Zip Code:33018
Practice Address - Country:US
Practice Address - Phone:305-827-7344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-02
Last Update Date:2019-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician