| Doctor Name: | IVANETTE COLON PASTRANA |
| NPI Number: | 1912355496 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMHC |
| License Number: | MH 13772 |
| Business Practice Address: | 7601 E Treasure Dr Cu1 North Bay Village, FL - 331414391 |
| Business Phone Number: | 3053028022 |
| Business Fax Number: | |
| Mailing Address: | 10800 Biscayne Blvd, Suite 440 MIAMI |
| State: | FL |
| Postal Code: | 331617482 |
| Phone Number: | 3057498617 |
| Fax Number: | |
| NPI Enumeration Date: | 05/25/2016 |
| NPI Last Update Date: | 05/25/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MH 13772 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |