Active NPI
Jaime Raul Picanol, PSY.D.
- Clinical Psychologist
- Miami, FL
National Provider Identifier
1306401286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY9057
- Practice address
- 9370 Sunset Dr Ste A213
Miami, FL 33173-5452 - Phone
- (305) 331-6011
- Fax
- (305) 242-5526
- NPI assigned
- May 6, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Psychologist | 103TF0200X | PY9057 | FL | |
| Clinical Psychologist | 103TC0700X | PY9057 | FL | Primary |
Addresses
Primary practice location
9370 Sunset Dr Ste A213
Miami, FL 33173-5452
Mailing address
4128 NE 30TH St
Homestead, FL 33033-5178
Phone (305) 331-6011
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY9057 | FL | MD | Forensic Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557100800000",
"number": "1306401286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4128 NE 30TH ST",
"city": "HOMESTEAD",
"state": "FL",
"postal_code": "330335178",
"telephone_number": "305-331-6011",
"fax_number": "305-242-5526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9370 SUNSET DR STE A213",
"city": "MIAMI",
"state": "FL",
"postal_code": "331735452",
"telephone_number": "305-331-6011",
"fax_number": "305-242-5526"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PICANOL",
"first_name": "JAIME",
"middle_name": "RAUL",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-05-06",
"last_updated": "2019-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "FL",
"license": "PY9057",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY9057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.