Provider Demographics
NPI:1659985026
Name:PAULINO, JUAN ARTURO (CRSS, CLC)
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:ARTURO
Last Name:PAULINO
Suffix:
Gender:M
Credentials:CRSS, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5112 CORONADO RDG
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-1444
Mailing Address - Country:US
Mailing Address - Phone:561-563-5574
Mailing Address - Fax:
Practice Address - Street 1:2400 W YAMATO RD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-8403
Practice Address - Country:US
Practice Address - Phone:561-241-9014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor