Provider Demographics
NPI:1588305031
Name:CERVANTES, ESTELLE VALERIE (MD)
Entity type:Individual
Prefix:
First Name:ESTELLE
Middle Name:VALERIE
Last Name:CERVANTES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 FAULKNER DR
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-2823
Mailing Address - Country:US
Mailing Address - Phone:908-821-6180
Mailing Address - Fax:
Practice Address - Street 1:14000 FIVAY RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-7103
Practice Address - Country:US
Practice Address - Phone:727-819-2966
Practice Address - Fax:727-819-2928
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-06
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty