Healthcare Provider Details

I. General information

NPI: 1699167601
Provider Name (Legal Business Name): NINA ESGUERRA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2015
Last Update Date: 02/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 CORPORATE DR SUITE 280
FORT LAUDERDALE FL
33334-3634
US

IV. Provider business mailing address

1000 CORPORATE DR SUITE 280
FORT LAUDERDALE FL
33334-3634
US

V. Phone/Fax

Practice location:
  • Phone: 954-636-2525
  • Fax:
Mailing address:
  • Phone: 954-636-2525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: