Provider Demographics
NPI:1750670832
Name:TORMO, JAIME F (BE)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:F
Last Name:TORMO
Suffix:
Gender:M
Credentials:BE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12516 SW 124TH PATH
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5421
Mailing Address - Country:US
Mailing Address - Phone:305-562-1658
Mailing Address - Fax:
Practice Address - Street 1:12516 SW 124TH PATH
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5421
Practice Address - Country:US
Practice Address - Phone:305-562-1658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-29
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003472400Medicaid