MEDICARE: MARIA TERESA ESTRADA 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
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1649611443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA TERESA ESTRADA LCSW

Provider Business Mailing Address
First Line	:	13216 SPRING HILL DR
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34609-5067
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13216 SPRING HILL DR
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34609-5067
Country	:	US
Telephone Number	:	352-346-4851
Fax Number	:

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

Provider Enumeration Date	:	07/10/2013
Last Update Date	:	07/10/2023

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