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General NPI Number Information
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NPI Number | 1942771381
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Entity Type | Individual
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Provider Name | ANDRES JOFFRE FRATICELLI SR. MSW
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Gender | Male
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Dates
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Enumeration Date | 12/11/2018
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Last Update Date | 07/21/2023
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Provider Practice Location Address
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Address Line | URB. VILLA SERENA CALLE VOLGA E7
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City | SANTA ISABEL
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State | PR
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Zip | 00757
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Country | US
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Telephone | 787-314-7849
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3415
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City | GUAYAMA
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State | PR
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Zip | 00785-3415
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Country | US
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Telephone | 787-590-4955
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 14603
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License Number State | PR
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