Healthcare Provider Details

I. General information

NPI: 1164227831
Provider Name (Legal Business Name): LIANKA CLODIA ESCARP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2025
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11780 SW 89TH ST STE 204
MIAMI FL
33186-2181
US

IV. Provider business mailing address

11780 SW 89TH ST STE 204
MIAMI FL
33186-2181
US

V. Phone/Fax

Practice location:
  • Phone: 305-846-9171
  • Fax:
Mailing address:
  • Phone: 305-846-9171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number21575
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: