MEDICARE: VIANA BERNABE JOSEPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1013637768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIANA BERNABE JOSEPH

Provider Business Mailing Address
First Line	:	12220 TOWNE LAKE DR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33913-8013
Country	:	US
Telephone Number	:	239-887-0435
Fax Number	:

Provider Business Practice Location Address
First Line	:	12220 TOWNE LAKE DR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33913-8013
Country	:	US
Telephone Number	:	239-887-0435
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2022
Last Update Date	:	04/06/2026

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Directions to “ VIANA BERNABE JOSEPH ” Practice Location

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