Provider Demographics
NPI:1407843428
Name:PINTALUGA, ANDRES J (MS LMHC)
Entity Type:Individual
Prefix:MR
First Name:ANDRES
Middle Name:J
Last Name:PINTALUGA
Suffix:
Gender:M
Credentials:MS LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5124 HOLLYWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6518
Mailing Address - Country:US
Mailing Address - Phone:954-894-1174
Mailing Address - Fax:954-965-4597
Practice Address - Street 1:5124 HOLLYWOOD BLVD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6518
Practice Address - Country:US
Practice Address - Phone:954-894-1174
Practice Address - Fax:954-965-4597
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH3313101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor