Provider Demographics
NPI:1093130049
Name:KUBER, JILL (PSYD)
Entity type:Individual
Prefix:DR
First Name:JILL
Middle Name:
Last Name:KUBER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 NE 183RD ST UNIT 303
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4477
Mailing Address - Country:US
Mailing Address - Phone:305-785-7858
Mailing Address - Fax:
Practice Address - Street 1:3301 NE 183RD ST UNIT 303
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33160-4477
Practice Address - Country:US
Practice Address - Phone:305-785-7858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6188103K00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103T00000XBehavioral Health & Social Service ProvidersPsychologist