Provider Demographics
NPI:1659177152
Name:ESTEFONT, LIVERTHA (RN, BSN)
Entity type:Individual
Prefix:
First Name:LIVERTHA
Middle Name:
Last Name:ESTEFONT
Suffix:
Gender:
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 RUBERTREE LANE
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467
Mailing Address - Country:US
Mailing Address - Phone:561-729-1029
Mailing Address - Fax:
Practice Address - Street 1:1240 SUMMERWOOD CIR
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-5147
Practice Address - Country:US
Practice Address - Phone:561-729-1029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9522904163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator