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NPI Code Detail

MEDICARE: MRS. VANESSA VICTORERO SAN MILLAN LCSW

MEDICARE:  MRS. VANESSA VICTORERO SAN MILLAN  LCSW
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
11041C0700XClinical Social WorkerSW21913FL

General Provider Information

NPI Number : 1619659869
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. VANESSA VICTORERO SAN MILLAN LCSW
Provider Business Mailing Address
First Line : 8021 SW 136TH AVE
Second Line :
City : MIAMI
State : FL
Zip : 33183-4142
Country : US
Telephone Number : 130-581-2944
Fax Number :
Provider Business Practice Location Address
First Line : 8021 SW 136TH AVE
Second Line :
City : MIAMI
State : FL
Zip : 33183-4142
Country : US
Telephone Number : 305-812-9440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2023
Last Update Date : 08/07/2023

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Directions to “ MRS. VANESSA VICTORERO SAN MILLAN LCSW” Practice Location

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