Healthcare Provider Details

I. General information

NPI: 1952216657
Provider Name (Legal Business Name): MIRELYS ESQUIVEL CBHCM-P
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14550 SW 51ST ST
MIAMI FL
33175-5710
US

IV. Provider business mailing address

14550 SW 51ST ST
MIAMI FL
33175-5710
US

V. Phone/Fax

Practice location:
  • Phone: 305-497-9032
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberCBHCM.0108374-P
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: