Healthcare Provider Details

I. General information

NPI: 1255172698
Provider Name (Legal Business Name): PATRICIA ESCANO GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2024
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2309 CANTOR LN
NORTH FORT MYERS FL
33917-2436
US

IV. Provider business mailing address

1107 SW 20TH AVE
CAPE CORAL FL
33991-2219
US

V. Phone/Fax

Practice location:
  • Phone: 239-265-6934
  • Fax:
Mailing address:
  • Phone: 239-265-6934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-335034
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: