Provider Demographics
NPI:1265957807
Name:NORELLA S. JUBIZ, PH.D., P.A.
Entity type:Organization
Organization Name:NORELLA S. JUBIZ, PH.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NORELLA
Authorized Official - Middle Name:S
Authorized Official - Last Name:JUBIZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:786-378-1745
Mailing Address - Street 1:200 SE 15TH RD APT 3H
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-1202
Mailing Address - Country:US
Mailing Address - Phone:786-378-1745
Mailing Address - Fax:
Practice Address - Street 1:2103 CORAL WAY STE 405
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33145-2630
Practice Address - Country:US
Practice Address - Phone:305-445-9554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-04
Last Update Date:2017-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9540103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty