Provider Demographics
NPI:1609134329
Name:ESTEVEZ, JOSE F (MT)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:F
Last Name:ESTEVEZ
Suffix:
Gender:M
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 E 7TH ST
Mailing Address - Street 2:APT 102
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-4461
Mailing Address - Country:US
Mailing Address - Phone:786-230-0617
Mailing Address - Fax:
Practice Address - Street 1:190 E 7TH ST
Practice Address - Street 2:APT 102
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-4461
Practice Address - Country:US
Practice Address - Phone:786-230-0617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-01
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA62425225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist