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General NPI Number Information
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NPI Number | 1316537830
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Entity Type | Individual
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Provider Name | JUAN P VILLATORO RMHCI
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Gender | Male
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Dates
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Enumeration Date | 01/19/2021
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Last Update Date | 01/19/2021
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Provider Practice Location Address
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Address Line | 6971 N FEDERAL HWY STE 206
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City | BOCA RATON
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State | FL
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Zip | 33487-1648
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Country | US
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Telephone | 561-408-1098
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Fax | 561-408-1099
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Provider Business Mailing Address
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Address Line | 729 MIDDLE ST
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City | FORT LAUDERDALE
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State | FL
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Zip | 33312-7158
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Country | US
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Telephone | 954-658-6299
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 13869
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License Number State | FL
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