Healthcare Provider Details

I. General information

NPI: 1275497992
Provider Name (Legal Business Name): ESPERANZA BELLA BARRERA EB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5568 NW 113TH AVE
DORAL FL
33178-3897
US

IV. Provider business mailing address

5568 NW 113TH AVE
DORAL FL
33178-3897
US

V. Phone/Fax

Practice location:
  • Phone: 305-790-3635
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License NumberBACB1284287
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: