Gaviria, Luis

Gaviria, Luis is an sole proprietor health care provider with primary practice located at 619 S Marion Ave , Lake City FL 32025-5808. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Gaviria, Luis can be contacted via phone (386) 755-3016.

Contact Information

Primary practice address
619 S Marion Ave Lake City FL 32025-5808
Phone: (386) 755-3016
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X SW5610 Florida

Profile Details

NPI number 1437226982
LBN Legal business name Gaviria, Luis
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 29th, 2006
Last updated Apr 17th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437226982 NPPES
Florida Other SW5610 STATE LICENSE NUMBER

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