Healthcare Provider Details

I. General information

NPI: 1730605361
Provider Name (Legal Business Name): JAVIER MARTIN ESCALONA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2017
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7376 LAKE WORTH RD
LAKE WORTH FL
33467-2529
US

IV. Provider business mailing address

7376 LAKE WORTH RD
LAKE WORTH FL
33467-2529
US

V. Phone/Fax

Practice location:
  • Phone: 561-460-5253
  • Fax:
Mailing address:
  • Phone: 561-460-5253
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-20-42248
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: