Healthcare Provider Details

I. General information

NPI: 1396253811
Provider Name (Legal Business Name): MISLEIDY ESQUIVEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2018
Last Update Date: 01/26/2023
Certification Date: 01/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13070 SW 262ND LN
HOMESTEAD FL
33032-8923
US

IV. Provider business mailing address

13070 SW 262ND LN
HOMESTEAD FL
33032-8923
US

V. Phone/Fax

Practice location:
  • Phone: 786-241-1231
  • Fax: 305-256-1663
Mailing address:
  • Phone: 786-710-1092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: