Active NPI
Rafael E. Fuentes, M.S.
- Mental Health Counselor
- Tampa, FL
National Provider Identifier
1215007620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- I.M.C. 5865
- Practice address
- 8019 N Himes Ave
Suite 400
Tampa, FL 33614-2712 - Phone
- (813) 732-6876
- Fax
- (813) 933-4625
- NPI assigned
- Nov 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | I.M.C. 5865 | FL | Primary |
Addresses
Primary practice location
8019 N Himes Ave
Suite 400
Tampa, FL 33614-2712
Mailing address
4073 Dolphin Dr
Tampa, FL 33617-7326
Phone (813) 732-6876
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I.M.C. 5865 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215007620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4073 DOLPHIN DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336177326",
"telephone_number": "813-732-6876",
"fax_number": "813-933-4625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8019 N HIMES AVE",
"address_2": "SUITE 400",
"city": "TAMPA",
"state": "FL",
"postal_code": "336142712",
"telephone_number": "813-732-6876",
"fax_number": "813-933-4625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUENTES",
"first_name": "RAFAEL",
"middle_name": "E.",
"name_prefix": "Mr.",
"credential": "M.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "I.M.C. 5865",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.