Healthcare Provider Details

I. General information

NPI: 1881482255
Provider Name (Legal Business Name): ESCUDERO HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2025
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15379 SW 24TH ST
MIAMI FL
33185-5739
US

IV. Provider business mailing address

15379 SW 24TH ST
MIAMI FL
33185-5739
US

V. Phone/Fax

Practice location:
  • Phone: 305-989-3037
  • Fax:
Mailing address:
  • Phone: 305-989-3037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: PEDRO T. ESCUDERO
Title or Position: MGR
Credential: OTR
Phone: 305-989-3037