Provider Demographics
NPI:1386989986
Name:CERDA, JOSIL (BHT)
Entity type:Individual
Prefix:
First Name:JOSIL
Middle Name:
Last Name:CERDA
Suffix:
Gender:F
Credentials:BHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 SUNSET RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33143-6022
Mailing Address - Country:US
Mailing Address - Phone:305-663-1733
Mailing Address - Fax:866-305-7365
Practice Address - Street 1:1234 S DIXIE HWY
Practice Address - Street 2:#348
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2902
Practice Address - Country:US
Practice Address - Phone:305-663-1733
Practice Address - Fax:866-305-7365
Is Sole Proprietor?:No
Enumeration Date:2012-12-07
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4961101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool