1518197466 NPI number — MRS. AELEEN B. GARRIDO-TORTORICI M.S., L.M.H.C.

Table of content: MRS. AELEEN B. GARRIDO-TORTORICI M.S., L.M.H.C. (NPI 1518197466)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518197466 NPI number — MRS. AELEEN B. GARRIDO-TORTORICI M.S., L.M.H.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GARRIDO-TORTORICI
Provider First Name:
AELEEN
Provider Middle Name:
B.
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.S., L.M.H.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518197466
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/30/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9126 GRIFFIN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COOPER CITY
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33328-3540
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-434-5784
Provider Business Mailing Address Fax Number:
954-434-5784

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9126 GRIFFIN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COOPER CITY
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33328-3540
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-434-5784
Provider Business Practice Location Address Fax Number:
954-434-5784
Provider Enumeration Date:
07/24/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  MH8121 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)