MEDICARE: VITOR CAETANO DE SOUZA

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
1	101YM0800X	Mental Health Counselor	IMH28244	FL

General Provider Information

NPI Number	:	1649156076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VITOR CAETANO DE SOUZA

Provider Business Mailing Address
First Line	:	7901 4TH ST N STE 300
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33702-4399
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	900 6TH AVE S STE 201
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34102-6745
Country	:	US
Telephone Number	:	239-293-7723
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2025
Last Update Date	:	08/12/2025

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Directions to “ VITOR CAETANO DE SOUZA ” Practice Location

Language	Start Address	Practice Location

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