Healthcare Provider Details

I. General information

NPI: 1780300764
Provider Name (Legal Business Name): ESPERANZA CONCEPT CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2022
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13195 SW 134TH ST STE 103
MIAMI FL
33186-4585
US

IV. Provider business mailing address

7340 SW 48TH ST STE 107A
MIAMI FL
33155-5520
US

V. Phone/Fax

Practice location:
  • Phone: 786-227-6830
  • Fax: 786-524-2413
Mailing address:
  • Phone: 786-227-6830
  • Fax: 786-524-2413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: DAYMI MARTIN
Title or Position: CEO
Credential: APRN, RN, CBHCMS
Phone: 786-227-6830