Healthcare Provider Details

I. General information

NPI: 1124646880
Provider Name (Legal Business Name): ESTEFANIA ESCOBAR M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2020
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 NE 19TH AVE
CAPE CORAL FL
33909-2715
US

IV. Provider business mailing address

321 NE 19TH AVE
CAPE CORAL FL
33909-2715
US

V. Phone/Fax

Practice location:
  • Phone: 786-397-0034
  • Fax:
Mailing address:
  • Phone: 786-397-0034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP013145
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA23693
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: