Provider Demographics
NPI:1912374125
Name:RESTO, ELIMAR (MSW)
Entity Type:Individual
Prefix:
First Name:ELIMAR
Middle Name:
Last Name:RESTO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:B18 CALLE 6
Mailing Address - Street 2:URB. VISTA MONTE
Mailing Address - City:CIDRA
Mailing Address - State:PR
Mailing Address - Zip Code:00739-3730
Mailing Address - Country:US
Mailing Address - Phone:787-410-7745
Mailing Address - Fax:
Practice Address - Street 1:B18 CALLE 6
Practice Address - Street 2:URB. VISTA MONTE
Practice Address - City:CIDRA
Practice Address - State:PR
Practice Address - Zip Code:00739-3730
Practice Address - Country:US
Practice Address - Phone:787-410-7745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11643104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker