Provider Demographics
NPI:1740096304
Name:ARCHEVAL, VICENTE
Entity type:Individual
Prefix:
First Name:VICENTE
Middle Name:
Last Name:ARCHEVAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 SENSOR PL APT 415
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-3696
Mailing Address - Country:US
Mailing Address - Phone:717-481-0020
Mailing Address - Fax:
Practice Address - Street 1:1111 SENSOR PL APT 415
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-3696
Practice Address - Country:US
Practice Address - Phone:717-481-0020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-09
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health