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General NPI Number Information
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NPI Number | 1235414186
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Entity Type | Individual
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Provider Name | JORGE JAVIER ESTEVEZ LMT
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Gender | Male
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Dates
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Enumeration Date | 10/11/2011
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Last Update Date | 10/11/2011
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Provider Practice Location Address
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Address Line | 2404 NW 87TH PL
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City | DORAL
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State | FL
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Zip | 33172-1201
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Country | US
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Telephone | 786-488-8615
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Fax | 866-698-1090
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Provider Business Mailing Address
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Address Line | 2404 NW 87TH PL
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City | DORAL
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State | FL
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Zip | 33172-1201
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Country | US
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Telephone | 786-488-8615
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Fax | 866-698-1090
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | MA51598
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License Number State | FL
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