Healthcare Provider Details

I. General information

NPI: 1558827105
Provider Name (Legal Business Name): YUSNEISY ESCALONA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2019
Last Update Date: 02/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3660 MAGUIRE BLVD STE 100
ORLANDO FL
32803-3059
US

IV. Provider business mailing address

3522 S PT DR
ORLANDO FL
32822-4073
US

V. Phone/Fax

Practice location:
  • Phone: 407-674-6870
  • Fax: 407-674-6873
Mailing address:
  • Phone: 407-325-9743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: