Healthcare Provider Details

I. General information

NPI: 1275028698
Provider Name (Legal Business Name): MARBELYS ESQUIJAROSA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2018
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20801 NW 2ND AVE
MIAMI FL
33169-2103
US

IV. Provider business mailing address

5940 SW 153RD CT
MIAMI FL
33193-2570
US

V. Phone/Fax

Practice location:
  • Phone: 305-653-1770
  • Fax: 786-725-3453
Mailing address:
  • Phone: 786-443-2432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9357333
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-390533
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: