Healthcare Provider Details

I. General information

NPI: 1942865431
Provider Name (Legal Business Name): ALEJANDRA ESCOBEDO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2019
Last Update Date: 07/03/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3202 10TH ST SW
LEHIGH ACRES FL
33976-2954
US

IV. Provider business mailing address

3202 10TH ST SW
LEHIGH ACRES FL
33976-2954
US

V. Phone/Fax

Practice location:
  • Phone: 239-360-6109
  • Fax:
Mailing address:
  • Phone: 863-234-5595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW21111
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: