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NPI Code Detail

MEDICARE: ELIDIO SURIEL

MEDICARE: ELIDIO SURIEL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1639663982
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIDIO SURIEL
Provider Business Mailing Address
First Line : 1621 E VINE ST
Second Line :
City : KISSIMMEE
State : FL
Zip : 34744-3730
Country : US
Telephone Number : 407-847-4152
Fax Number :
Provider Business Practice Location Address
First Line : 1621 E VINE ST
Second Line :
City : KISSIMMEE
State : FL
Zip : 34744-3730
Country : US
Telephone Number : 407-847-4152
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2018
Last Update Date : 06/20/2018

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Directions to “ ELIDIO SURIEL ” Practice Location

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