Healthcare Provider Details

I. General information

NPI: 1013851302
Provider Name (Legal Business Name): EMESHA JEAN-BAPTISTE
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12750 NW 17TH ST
MIAMI FL
33182-1420
US

IV. Provider business mailing address

12750 NW 17TH ST
MIAMI FL
33182-1420
US

V. Phone/Fax

Practice location:
  • Phone: 888-527-8037
  • Fax:
Mailing address:
  • Phone: 888-527-8037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-448761
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: