Provider Demographics
NPI:1134906001
Name:PUJOL TESTAR, GILBERTO MANUEL
Entity type:Individual
Prefix:
First Name:GILBERTO
Middle Name:MANUEL
Last Name:PUJOL TESTAR
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 1:4700 SW 142ND CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-4323
Mailing Address - Country:US
Mailing Address - Phone:786-820-1478
Mailing Address - Fax:
Practice Address - Street 1:4700 SW 142ND CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-4323
Practice Address - Country:US
Practice Address - Phone:786-820-1478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst