Healthcare Provider Details

I. General information

NPI: 1144871112
Provider Name (Legal Business Name): JOSHUA ESTEVANELL PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2019
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2760 SW 142ND CT
MIAMI FL
33175-6554
US

IV. Provider business mailing address

2760 SW 142ND CT
MIAMI FL
33175-6554
US

V. Phone/Fax

Practice location:
  • Phone: 305-389-1247
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA26880
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-85673
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-461991
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: