Active NPI
Esta Tudela, LCSW
- Clinical Social Worker
- Miramar, FL
National Provider Identifier
1790561660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW22029
- Practice address
- 6143 SW 33Rd St Apt a
Miramar, FL 33023-5324 - Phone
- (786) 715-3039
- NPI assigned
- Sep 6, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW22029 | FL | Primary |
Addresses
Primary practice location
6143 SW 33Rd St Apt a
Miramar, FL 33023-5324
Mailing address
6143 SW 33Rd St Apt a
Miramar, FL 33023-5324
Phone (786) 715-3039
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
| License | State | Type | Specialty |
|---|---|---|---|
| SW22029 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693958400000",
"number": "1790561660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6143 SW 33RD ST APT A",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330235324",
"telephone_number": "786-715-3039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6143 SW 33RD ST APT A",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330235324",
"telephone_number": "786-715-3039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUDELA",
"first_name": "ESTA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-09-06",
"last_updated": "2023-09-06",
"certification_date": "2023-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW22029",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miramar, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.