Provider Demographics
NPI:1427759083
Name:JUGO, EHLIMANA
Entity type:Individual
Prefix:
First Name:EHLIMANA
Middle Name:
Last Name:JUGO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6225 KENDALE LAKES CIR APT D260
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-1954
Mailing Address - Country:US
Mailing Address - Phone:404-226-1567
Mailing Address - Fax:
Practice Address - Street 1:6225 KENDALE LAKES CIR APT D260
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-1954
Practice Address - Country:US
Practice Address - Phone:404-226-1567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty