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General NPI Number Information
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NPI Number | 1174043368
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Entity Type | Individual
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Provider Name | JOHN ALEXIS ESBERG MASTER SOCIAL WORKER
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Gender | Male
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Dates
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Enumeration Date | 06/20/2017
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Last Update Date | 06/20/2017
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Provider Practice Location Address
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Address Line | R13 CALLE MARINA URB. DORADO DEL MAR
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City | DORADO
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State | PR
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Zip | 00646
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Country | US
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Telephone | 787-485-1405
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Fax |
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Provider Business Mailing Address
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Address Line | R13 CALLE MARINA URB DORADO DEL MAR
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City | DORADO
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State | PR
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Zip | 00646
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Country | US
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Telephone | 787-485-1405
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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 | 9642
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License Number State | PR
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