Provider Demographics
NPI:1992827216
Name:BORDIGNON, GIOVANNI BATTISTA (LMHC)
Entity Type:Individual
Prefix:MR
First Name:GIOVANNI
Middle Name:BATTISTA
Last Name:BORDIGNON
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10565 52ND AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33708-3311
Mailing Address - Country:US
Mailing Address - Phone:727-391-1811
Mailing Address - Fax:
Practice Address - Street 1:10823 SEMINOLE BLVD
Practice Address - Street 2:SUITE 2B
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33778-3347
Practice Address - Country:US
Practice Address - Phone:727-392-1812
Practice Address - Fax:727-392-0856
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH004458101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004458MHOtherLICENCE