Provider Information for 1295471431
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JUAN J COBO LMHC
Sex: Male
NPI: 1295471431
Last Updated: 2025-01-09
Certification Date: 2025-01-09
Certification Date: 2025-01-09
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1295471431 | ||||||||||||
| Enumeration Date | 2022-05-10 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 4020 NW 64TH PL GAINESVILLE, FL 32653-8372 United States Phone: 954-544-7401 | Fax: | ||||||||||||
| Primary Practice Address | 4020 NW 64TH PL GAINESVILLE, FL 32653-8372 United States Phone: 954-544-7401 | Fax: | ||||||||||||
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