Provider Demographics
NPI:1336450196
Name:VENTO, ROBERT MIGUEL (MS,MFT)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:MIGUEL
Last Name:VENTO
Suffix:
Gender:M
Credentials:MS,MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 KINGWAY DR
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-8604
Mailing Address - Country:US
Mailing Address - Phone:386-860-5289
Mailing Address - Fax:
Practice Address - Street 1:1811 KINGWAY DR
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32725-8604
Practice Address - Country:US
Practice Address - Phone:386-860-5289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-27
Last Update Date:2010-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMT227106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist