Healthcare Provider Details
I. General information
NPI: 1194330175
Provider Name (Legal Business Name): HERLIENI ESCALERA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/15/2020
Last Update Date: 08/14/2024
Certification Date: 08/14/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10000 W COLONIAL DR STE 289
OCOEE FL
34761-3432
US
IV. Provider business mailing address
10000 W COLONIAL DR STE 289
OCOEE FL
34761-3432
US
V. Phone/Fax
- Phone: 321-841-4344
- Fax: 321-842-4767
- Phone: 321-841-4344
- Fax: 321-842-4767
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | 11009158 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LA2200X |
| Taxonomy | Adult Health Nurse Practitioner |
| License Number | APRN11009158 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: