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General NPI Number Information
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NPI Number | 1447999131
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Entity Type | Individual
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Provider Name | JOSE YAMIL MONTANEZ AGOSTO MSW
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Gender | Male
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Dates
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Enumeration Date | 06/01/2022
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Last Update Date | 06/02/2022
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Provider Practice Location Address
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Address Line | BO. MAMEY I CARR. 189 KM 8.2
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City | GURABO
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State | PR
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Zip | 00778
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Country | US
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Telephone | 787-961-6687
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Fax |
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Provider Business Mailing Address
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Address Line | J14 CALLE 10
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City | GURABO
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State | PR
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Zip | 00778-2145
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Country | US
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Telephone | 787-215-7897
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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 | 12870
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License Number State | PR
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