Healthcare Provider Details

I. General information

NPI: 1306271853
Provider Name (Legal Business Name): VILMARIE ESCUDERO GUERRIOS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2013
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2015 CALM SOUL WAY
KISSIMMEE FL
34744-6509
US

IV. Provider business mailing address

2015 CALM SOUL WAY
KISSIMMEE FL
34744-6509
US

V. Phone/Fax

Practice location:
  • Phone: 321-393-1145
  • Fax:
Mailing address:
  • Phone: 321-393-1145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA13667
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: