Provider Demographics
NPI:1306518030
Name:TASENDE MURIEDAS, JOSE L (CBHCM)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:L
Last Name:TASENDE MURIEDAS
Suffix:
Gender:M
Credentials:CBHCM
Other - Prefix:MR
Other - First Name:JOSE
Other - Middle Name:L
Other - Last Name:TASENDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CBHCM
Mailing Address - Street 1:30241 SW 152ND AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-3605
Mailing Address - Country:US
Mailing Address - Phone:786-424-3399
Mailing Address - Fax:
Practice Address - Street 1:30241 SW 152ND AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-3605
Practice Address - Country:US
Practice Address - Phone:786-424-3399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-30
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator