Healthcare Provider Details

I. General information

NPI: 1326818865
Provider Name (Legal Business Name): CLAUDIA JESSICA ESQUIVEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2024
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15230 SW 300TH ST
HOMESTEAD FL
33033-3624
US

IV. Provider business mailing address

15230 SW 300TH ST
HOMESTEAD FL
33033-3624
US

V. Phone/Fax

Practice location:
  • Phone: 772-362-9878
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-311568
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: