Provider Demographics
NPI:1396567293
Name:OROZCO, JONATHAN DANIEL
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:DANIEL
Last Name:OROZCO
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 1:24953 SW 129TH PL
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-9041
Mailing Address - Country:US
Mailing Address - Phone:786-560-3434
Mailing Address - Fax:
Practice Address - Street 1:24953 SW 129TH PL
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-9041
Practice Address - Country:US
Practice Address - Phone:786-560-3434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-30
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-385166103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst