Healthcare Provider Details

I. General information

NPI: 1366055675
Provider Name (Legal Business Name): MARIA CHRISTINA TIJERINA ESQUIVEL FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2020
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12612 CHALLENGER PKWY STE 365
ORLANDO FL
32826-2784
US

IV. Provider business mailing address

21127 EL SUELO BUENO
SAN ANTONIO TX
78258-2926
US

V. Phone/Fax

Practice location:
  • Phone: 407-306-8441
  • Fax:
Mailing address:
  • Phone: 210-265-7569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1003566
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: