Individual
MR. BONAVENTURAS MICHAEL VYZAS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
16544 N DALE MABRY HWY, TAMPA, FL 33618-1325
(813) 960-8622
(813) 960-1554
Mailing address
16544 N DALE MABRY HWY, TAMPA, FL 33618-1325
(813) 960-8622
(813) 960-1554
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH0001886
FL
Other
Enumeration date
12/29/2005
Last updated
07/08/2007
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