Provider Demographics
NPI:1255769600
Name:JUBER COMPLETE HEALTH
Entity type:Organization
Organization Name:JUBER COMPLETE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOREDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-345-2055
Mailing Address - Street 1:13550 SW 88TH ST
Mailing Address - Street 2:SUITE 174
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1654
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13550 SW 88TH ST
Practice Address - Street 2:SUITE 174
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1654
Practice Address - Country:US
Practice Address - Phone:305-345-2055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JUBER IMAGING, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-22
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC8880111N00000X, 225100000X, 225700000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty