Individual
CARMINE VIDANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
8900 SW 168TH ST, PALMETTO BAY, FL 33157-4569
(786) 430-1051
Mailing address
5937 SW 133RD CT, MIAMI, FL 33183-5126
(786) 423-0751
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH12397
FL
Other
Enumeration date
06/13/2014
Last updated
06/13/2014
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