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General NPI Number Information
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NPI Number | 1093019101
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Entity Type | Individual
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Provider Name | JORGE ALMODOVAR CAPIELO MSW
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Gender | Male
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Dates
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Enumeration Date | 01/04/2011
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Last Update Date | 09/21/2016
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Provider Practice Location Address
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Address Line | 3155 AVE JULIO E MONAGAS URB. CONSTANCIA
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City | PONCE
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State | PR
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Zip | 00717-2205
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Country | US
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Telephone | 787-347-9815
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Fax |
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Provider Business Mailing Address
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Address Line | 3155 AVE JULIO E MONAGAS URB. CONSTANCIA
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City | PONCE
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State | PR
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Zip | 00717-2205
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 9932
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License Number State | PR
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