Provider Demographics
NPI:1639385792
Name:PREZIOSO, VICTOR JAMES (RNC CD)
Entity type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:JAMES
Last Name:PREZIOSO
Suffix:
Gender:M
Credentials:RNC CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3590 N HIGHWAY 17/92
Mailing Address - Street 2:SUITE 1026
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-4510
Mailing Address - Country:US
Mailing Address - Phone:407-321-7015
Mailing Address - Fax:407-321-7195
Practice Address - Street 1:3590 N HIGHWAY 17/92
Practice Address - Street 2:SUITE 1026
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-4510
Practice Address - Country:US
Practice Address - Phone:407-321-7015
Practice Address - Fax:407-321-7195
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2093232101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor