Provider Demographics
NPI:1942830187
Name:ESTEVEZ GIL, OSMANY (BA)
Entity Type:Individual
Prefix:
First Name:OSMANY
Middle Name:
Last Name:ESTEVEZ GIL
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 NW 201ST TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-1427
Mailing Address - Country:US
Mailing Address - Phone:786-378-9197
Mailing Address - Fax:305-320-3053
Practice Address - Street 1:3800 NW 201ST TER
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33055-1427
Practice Address - Country:US
Practice Address - Phone:786-378-9197
Practice Address - Fax:305-320-3053
Is Sole Proprietor?:No
Enumeration Date:2020-01-15
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician