MEDICARE: JOSE FERNANDO NATER SOCIAL WORKER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	4315	PR

General Provider Information

NPI Number	:	1245583905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE FERNANDO NATER SOCIAL WORKER

Provider Business Mailing Address
First Line	:	UNIVERSITY GARDENS
Second Line	:	CORNELL 220
City	:	SAN JUAN
State	:	PR
Zip	:	00927
Country	:	US
Telephone Number	:	939-257-1045
Fax Number	:

Provider Business Practice Location Address
First Line	:	220 CALLE CORNELL
Second Line	:	UNIVERSITY GARDENS
City	:	SAN JUAN
State	:	PR
Zip	:	00927-4123
Country	:	US
Telephone Number	:	939-257-1045
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2012
Last Update Date	:	10/18/2012

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