Provider Demographics
NPI:1497421663
Name:NAVEDO RESTO, SUHEILY
Entity Type:Individual
Prefix:
First Name:SUHEILY
Middle Name:
Last Name:NAVEDO RESTO
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:HC 2 BOX 13838
Mailing Address - Street 2:
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-9805
Mailing Address - Country:US
Mailing Address - Phone:787-433-8018
Mailing Address - Fax:
Practice Address - Street 1:BO. FLORIDA SECTOR ZARZAL
Practice Address - Street 2:CARR. 183 R 928
Practice Address - City:SAN LORENZO
Practice Address - State:PR
Practice Address - Zip Code:00754
Practice Address - Country:US
Practice Address - Phone:787-433-8018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR155751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR15575OtherSOCIAL WORKER WITH PERMANENT LICENSE