1720076789 NPI number — MS. ELSIE ESTELA CALAFELL FLERES LCSW

Table of content: MS. ELSIE ESTELA CALAFELL FLERES LCSW (NPI 1720076789)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720076789 NPI number — MS. ELSIE ESTELA CALAFELL FLERES LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CALAFELL FLERES
Provider First Name:
ELSIE
Provider Middle Name:
ESTELA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FLERES
Provider Other First Name:
ELSIE
Provider Other Middle Name:
ESTELA
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1720076789
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9260 SUNSET DR
Provider Second Line Business Mailing Address:
SUNSET OAKS SUITE 118
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33173-3275
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-962-6665
Provider Business Mailing Address Fax Number:
305-595-5403

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9260 SUNSET DR
Provider Second Line Business Practice Location Address:
SUNSET OAKS SUITE 118
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33173-3275
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-962-6665
Provider Business Practice Location Address Fax Number:
305-595-5403
Provider Enumeration Date:
10/12/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  FLSW2325 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 76158500 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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