Healthcare Provider Details

I. General information

NPI: 1134592439
Provider Name (Legal Business Name): NARVIC JOAN BITTAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2015
Last Update Date: 11/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1028 E OSCEOLA PKWY
KISSIMMEE FL
34744-1607
US

IV. Provider business mailing address

3102 MANDOLIN DR
KISSIMMEE FL
34744-9171
US

V. Phone/Fax

Practice location:
  • Phone: 407-720-4651
  • Fax: 407-720-4690
Mailing address:
  • Phone: 407-860-5383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: