Provider Demographics
NPI:1710911342
Name:VILLARINI, FERNANDO (MA)
Entity Type:Individual
Prefix:MR
First Name:FERNANDO
Middle Name:
Last Name:VILLARINI
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 URB SERENNA
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-3300
Mailing Address - Country:US
Mailing Address - Phone:787-374-9744
Mailing Address - Fax:787-704-0870
Practice Address - Street 1:AVE. GAUTIER BENITEZ CONSOLIDATED MALL ANEXO B-5
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-704-0705
Practice Address - Fax:787-704-0870
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2315103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling