Healthcare Provider Details

I. General information

NPI: 1184104945
Provider Name (Legal Business Name): MS. ADILEN ESQUIVEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2018
Last Update Date: 08/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9730 NW 3RD ST
PEMBROKE PINES FL
33024-6208
US

IV. Provider business mailing address

9730 NW 3RD ST
PEMBROKE PINES FL
33024-6208
US

V. Phone/Fax

Practice location:
  • Phone: 754-207-7249
  • Fax:
Mailing address:
  • Phone: 754-207-7249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP9199354
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: