Healthcare Provider Details

I. General information

NPI: 1457020265
Provider Name (Legal Business Name): GISELLE ESCARLET SENCION
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2021
Last Update Date: 09/07/2021
Certification Date: 09/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3810 INVERRARY BLVD STE 101
LAUDERHILL FL
33319-4380
US

IV. Provider business mailing address

4550 W TRADEWINDS AVE
LAUDERDALE BY THE SEA FL
33308-3540
US

V. Phone/Fax

Practice location:
  • Phone: 954-587-1210
  • Fax:
Mailing address:
  • Phone: 646-920-4824
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ10321
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: