Provider Demographics
NPI:1962620344
Name:CELOTTI, VILMA C (MS)
Entity type:Individual
Prefix:
First Name:VILMA
Middle Name:C
Last Name:CELOTTI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8484 SW 181ST TER
Mailing Address - Street 2:
Mailing Address - City:VILLAGE OF PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-6052
Mailing Address - Country:US
Mailing Address - Phone:305-238-0388
Mailing Address - Fax:
Practice Address - Street 1:9380 SW 72ND ST # 120
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3276
Practice Address - Country:US
Practice Address - Phone:305-274-3172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLNONEMedicaid