Healthcare Provider Details

I. General information

NPI: 1114622008
Provider Name (Legal Business Name): SARAI SIENIE CHUECOS ESCALANTE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11225 MIRAMAR PKWY STE 210
MIRAMAR FL
33025-1965
US

IV. Provider business mailing address

8913 WALTHAM WOODS RD APT C
PARKVILLE MD
21234-2452
US

V. Phone/Fax

Practice location:
  • Phone: 954-202-0647
  • Fax: 954-337-6116
Mailing address:
  • Phone: 786-344-7760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME180277
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: