Healthcare Provider Details

I. General information

NPI: 1265106520
Provider Name (Legal Business Name): YORBANIA OFELIA LLUCH ESCOBAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2021
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8461 LAKE WORTH RD STE 108
LAKE WORTH FL
33467-2474
US

IV. Provider business mailing address

2004 WATERVIEW CIR
PALM SPRINGS FL
33461-6437
US

V. Phone/Fax

Practice location:
  • Phone: 305-562-7884
  • Fax:
Mailing address:
  • Phone: 561-787-4070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-21-150360
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: