Individual provider Active NPI

Gladyvette Estevez

  • Clinical Social Worker
  • Mayaguez, PR
National Provider Identifier
1043769920
Registry record updated Oct 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10511 Issued in PR
Practice address
410 Ave Hostos Ste 7
Mayaguez, PR 00682-1500
Phone
(787) 833-0663
NPI assigned
Oct 3, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 10511 PR Primary

Addresses

Primary practice location

410 Ave Hostos Ste 7
Mayaguez, PR 00682-1500

Mailing address

54 Calle Eduardo Riera
Mayaguez, PR 00680-3810
Phone (787) 340-3821

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10511PRMDInternal Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475452800000",
    "number": "1043769920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 CALLE EDUARDO RIERA",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006803810",
            "telephone_number": "787-340-3821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 AVE HOSTOS STE 7",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006821500",
            "telephone_number": "787-833-0663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTEVEZ",
        "first_name": "GLADYVETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-03",
        "last_updated": "2016-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PR",
            "license": "10511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.