Healthcare Provider Details

I. General information

NPI: 1275217929
Provider Name (Legal Business Name): RAINER MICHEL ESQUIJAROSA R.B.T
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2023
Last Update Date: 06/13/2023
Certification Date: 06/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7332 SW 163RD CT
MIAMI FL
33193-5154
US

IV. Provider business mailing address

7332 SW 163RD CT
MIAMI FL
33193-5154
US

V. Phone/Fax

Practice location:
  • Phone: 786-662-9842
  • Fax:
Mailing address:
  • Phone: 786-662-9842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT23277001
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: