Dr Elena Coello-Jemmali Inc

Organization Active NPI Clinical Neuropsychologist · Palmetto Bay, FL

NPI 1801099155 · NPPES record last updated Jun 24, 2008

Key facts

NPI
1801099155
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Neuropsychologist 103G00000X
License
PY04371 (FL)
Legal business name
DR ELENA COELLO-JEMMALI INC
Practice address
14707 S Dixie Hwy
#211
Palmetto Bay, FL 33176-7948
Phone
(305) 233-2010
Fax
(305) 233-2011
NPI assigned
Jun 6, 2007
Organization subpart
No

Authorized official

Name
Dr. Elena Coello Jemmali, PSYD
Title
Physician
Phone
(305) 233-2010

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in FL, TN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20051008000031 FL Part B Supplier - Clinic/Group Practice 6103841267 Receives reassigned benefits from 1 practitioner
Practice locations: Palmetto Bay, FL
O20230815003344 TN Part B Supplier - Clinic/Group Practice 6103841267 Receives reassigned benefits from 1 practitioner
Practice locations: Johnson City, TN

National Provider Directory

Locations

206 Princeton Rd
Ste 41
Johnson City, TN 37601
Phone (305) 233-2010

Networks

  • HealthSun Health Plans Network

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist
Group: 193400000X SINGLE SPECIALTY GROUP
103G00000X PY04371 FL Yes

Addresses

Primary practice location

14707 S Dixie Hwy
#211
Palmetto Bay, FL 33176-7948

Mailing address

14707 S Dixie Hwy
#211
Palmetto Bay, FL 33176-7948
Phone (305) 233-2010

Other providers in Palmetto Bay, FL

All providers in Palmetto Bay, FL · Clinical Neuropsychologist in Florida

Sources for this page

Verify at the official NPI Registry.