Provider Demographics
NPI:1992430185
Name:JOLIBOIS, PATRICK KOBY
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:KOBY
Last Name:JOLIBOIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1948 SE 24TH TER
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33035-2071
Mailing Address - Country:US
Mailing Address - Phone:786-545-5985
Mailing Address - Fax:
Practice Address - Street 1:11420 N KENDALL DR STE 112
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1039
Practice Address - Country:US
Practice Address - Phone:305-279-1999
Practice Address - Fax:305-459-3270
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician