Provider Demographics
NPI:1639818677
Name:HIRALDO, JAMIE FERMIN
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:FERMIN
Last Name:HIRALDO
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 1:1879 NE 182ND ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-1524
Mailing Address - Country:US
Mailing Address - Phone:786-838-9202
Mailing Address - Fax:
Practice Address - Street 1:1879 NE 182ND ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-1524
Practice Address - Country:US
Practice Address - Phone:786-838-9202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-28
Last Update Date:2022-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician