Provider Demographics
NPI:1700622701
Name:ARAUJO, ALBERTO CARDOSO
Entity type:Individual
Prefix:
First Name:ALBERTO
Middle Name:CARDOSO
Last Name:ARAUJO
Suffix:
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 1:405 TUMBLED STONE WAY
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-0255
Mailing Address - Country:US
Mailing Address - Phone:908-347-4538
Mailing Address - Fax:
Practice Address - Street 1:1700 WELLS RD
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-2337
Practice Address - Country:US
Practice Address - Phone:908-347-4538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH23950101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health