Provider Demographics
NPI:1801765821
Name:VISVALINGAM, CATRINA IMANI
Entity type:Individual
Prefix:
First Name:CATRINA
Middle Name:IMANI
Last Name:VISVALINGAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8461 RIVER BRANCH PL
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-8358
Mailing Address - Country:US
Mailing Address - Phone:407-406-2722
Mailing Address - Fax:
Practice Address - Street 1:4302 W EL PRADO BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-8405
Practice Address - Country:US
Practice Address - Phone:813-461-5380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-30
Last Update Date:2025-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician