Joan Alice Carrillo, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

JOAN ALICE CARRILLO, PH.D.

Practice address

7901 SW 67TH Ave
201
South Miami, FL 33143-4538

Phone

(305) 666-7055

Fax

(786) 349-0144

NPI assigned

May 12, 2016

Last updated

May 12, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Joan Alice Carrillo, PH.D.

Title

Clinical Psychologist

Phone

(305) 666-7055

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1463011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463011200000",
    "number": "1558717157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 SW 67TH AVE",
            "address_2": "201",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434538",
            "telephone_number": "305-666-7055",
            "fax_number": "786-349-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 SW 67TH AVE",
            "address_2": "201",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434538",
            "telephone_number": "305-666-7055",
            "fax_number": "786-349-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOAN ALICE CARRILLO, PH.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-12",
        "last_updated": "2016-05-12",
        "status": "A",
        "authorized_official_last_name": "CARRILLO",
        "authorized_official_first_name": "JOAN",
        "authorized_official_middle_name": "ALICE",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "305-666-7055",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "73918",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ana Michelle Jimenez, PA-C
• Christopher Alexander Jimenez, M.D.
• Francisco R Jimenez, M.D.
• Gihanna Barbara Jimenez, PH.D.
• Glendy Jimenez, MD
• Joaquin Novoa
• Joaquin Novoa
• Wendy Joffe, PSY.D.
• John Anthony Joffre, D.D.S.
• John Cassel MD PA

• Psychologist in South Miami, FL
• Providers in South Miami, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.