Provider Demographics
NPI:1538981915
Name:VIERA CALDERON, EDGARDO JAVIER (MSW)
Entity type:Individual
Prefix:MR
First Name:EDGARDO
Middle Name:JAVIER
Last Name:VIERA CALDERON
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 AVE PONCE DE LEON
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00917-3424
Mailing Address - Country:US
Mailing Address - Phone:787-641-2323
Mailing Address - Fax:
Practice Address - Street 1:435 AVE PONCE DE LEON
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-3424
Practice Address - Country:US
Practice Address - Phone:787-641-2323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR167421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical