Provider Demographics
NPI:1972218154
Name:VEINTEMILLA, CARLOS JR
Entity type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:
Last Name:VEINTEMILLA
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1042 NW 127TH PATH
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33182-1830
Mailing Address - Country:US
Mailing Address - Phone:305-989-1206
Mailing Address - Fax:
Practice Address - Street 1:1042 NW 127TH PATH
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33182-1830
Practice Address - Country:US
Practice Address - Phone:305-989-1206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-23
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician