Provider Demographics
NPI:1649021312
Name:URQUIA, JOSE MIGUEL
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:MIGUEL
Last Name:URQUIA
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 1:2775 W 12TH AVE APT 19
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-6021
Mailing Address - Country:US
Mailing Address - Phone:786-846-5296
Mailing Address - Fax:
Practice Address - Street 1:2775 W 12TH AVE APT 19
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-6021
Practice Address - Country:US
Practice Address - Phone:786-846-5296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-29
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty