Doctor Name: | ANGEL M AGUASVIVAS |
NPI Number: | 1003143694 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MHC |
License Number: | MH10008 |
Business Practice Address: | 7501 Wiles Rd Ste 105 Coral Springs, FL - 330672063 |
Business Phone Number: | 9543411022 |
Business Fax Number: | |
Mailing Address: | 7501 Wiles Rd Ste 105, CORAL SPRINGS |
State: | FL |
Postal Code: | 330672063 |
Phone Number: | 9543411022 |
Fax Number: | |
NPI Enumeration Date: | 11/03/2009 |
NPI Last Update Date: | 11/03/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MH10008 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |