Healthcare Provider Details

I. General information

NPI: 1902794118
Provider Name (Legal Business Name): MARIA KARLA ESCOBAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2025
Last Update Date: 06/26/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18217 SW 148TH AVE RD
MIAMI FL
33187-1883
US

IV. Provider business mailing address

18217 SW 148TH AVE RD
MIAMI FL
33187-1883
US

V. Phone/Fax

Practice location:
  • Phone: 786-879-6048
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number11039799
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: