Provider Demographics
NPI:1417434937
Name:FERNANDINI, GIOVANNI DAVID (RBT)
Entity Type:Individual
Prefix:
First Name:GIOVANNI
Middle Name:DAVID
Last Name:FERNANDINI
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2305 N CONGRESS AVE APT 36
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8644
Mailing Address - Country:US
Mailing Address - Phone:561-252-9116
Mailing Address - Fax:
Practice Address - Street 1:2305 N CONGRESS AVE APT 36
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8644
Practice Address - Country:US
Practice Address - Phone:561-252-9116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-26
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty