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General NPI Number Information
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NPI Number | 1174915912
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Entity Type | Individual
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Provider Name | MR. JAVIER VERDIN
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Gender | Male
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Dates
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Enumeration Date | 03/03/2015
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Last Update Date | 12/08/2018
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Provider Practice Location Address
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Address Line | 3307 NORTHLAKE BLVD STE 104
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33403-1703
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Country | US
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Telephone | 561-531-1204
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Fax |
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Provider Business Mailing Address
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Address Line | 3117 31ST WAY
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-6711
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH16499
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License Number State | FL
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