Healthcare Provider Details

I. General information

NPI: 1477092674
Provider Name (Legal Business Name): ISAEL ESCALONA SR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2017
Last Update Date: 02/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9800 HAITIAN DR
CUTLER BAY FL
33189-1612
US

IV. Provider business mailing address

9800 HAITIAN DR
CUTLER BAY FL
33189-1612
US

V. Phone/Fax

Practice location:
  • Phone: 786-302-5303
  • Fax: 786-701-2904
Mailing address:
  • Phone: 786-302-5303
  • Fax: 786-701-2904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: