Healthcare Provider Details

I. General information

NPI: 1134013550
Provider Name (Legal Business Name): YAIMA ESCANDON I
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 06/09/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 SW 10TH TER
HALLANDALE BEACH FL
33009-3300
US

IV. Provider business mailing address

330 SW 10TH TER
HALLANDALE BEACH FL
33009-6125
US

V. Phone/Fax

Practice location:
  • Phone: 786-236-4301
  • Fax:
Mailing address:
  • Phone: 786-236-4301
  • Fax:

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: