Healthcare Provider Details

I. General information

NPI: 1366263154
Provider Name (Legal Business Name): LAURA ESTEFANIA VITTI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2024
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 N COMMERCE PKWY STE 7
WESTON FL
33326-3238
US

IV. Provider business mailing address

2741 EXECUTIVE PARK DR STE 1
WESTON FL
33331-3641
US

V. Phone/Fax

Practice location:
  • Phone: 754-206-6697
  • Fax:
Mailing address:
  • Phone: 954-623-0963
  • 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: