Healthcare Provider Details

I. General information

NPI: 1467363879
Provider Name (Legal Business Name): NEIVIS CARAM ESCALONA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 CLARK RD STE B3
SARASOTA FL
34233-2369
US

IV. Provider business mailing address

3900 CLARK RD STE B3
SARASOTA FL
34233-2369
US

V. Phone/Fax

Practice location:
  • Phone: 941-914-5272
  • Fax: 941-296-8441
Mailing address:
  • Phone: 941-914-5272
  • Fax: 941-296-8441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-2848389
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: