Provider Demographics
NPI:1891195301
Name:ARCHER, EDVARDO (LMFT)
Entity Type:Individual
Prefix:
First Name:EDVARDO
Middle Name:
Last Name:ARCHER
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3730 INVERRARY DR
Mailing Address - Street 2:APT 3W
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33319-5120
Mailing Address - Country:US
Mailing Address - Phone:561-707-6150
Mailing Address - Fax:
Practice Address - Street 1:3730 INVERRARY DR
Practice Address - Street 2:APT 3W
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-5120
Practice Address - Country:US
Practice Address - Phone:561-707-6150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-03
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT 2684106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist