Provider Demographics
NPI:1457647794
Name:CESTERO, VILMARIS I
Entity Type:Individual
Prefix:
First Name:VILMARIS
Middle Name:I
Last Name:CESTERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. JESUS M. LAGO
Mailing Address - Street 2:E-13
Mailing Address - City:UTUADO
Mailing Address - State:PR
Mailing Address - Zip Code:00641
Mailing Address - Country:US
Mailing Address - Phone:787-617-7813
Mailing Address - Fax:
Practice Address - Street 1:URB. JESUS M. LAGO
Practice Address - Street 2:E-13
Practice Address - City:UTUADO
Practice Address - State:PR
Practice Address - Zip Code:00641
Practice Address - Country:US
Practice Address - Phone:787-617-7813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-24
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR003204103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist