Provider Demographics
NPI:1356161178
Name:GERMEIL, DEBORAH
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:GERMEIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:
Other - Last Name:GERMEIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DEBORAH GERMEIL
Mailing Address - Street 1:21131 NE 13TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-1322
Mailing Address - Country:US
Mailing Address - Phone:786-805-2307
Mailing Address - Fax:
Practice Address - Street 1:21131 NE 13TH PL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-1322
Practice Address - Country:US
Practice Address - Phone:786-805-2307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-15
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-353746106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty