Healthcare Provider Details

I. General information

NPI: 1114671740
Provider Name (Legal Business Name): KARLA MARIA ESCOBAR BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2022
Last Update Date: 09/27/2024
Certification Date: 09/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 SW 57TH AVE STE 205
SOUTH MIAMI FL
33143-5542
US

IV. Provider business mailing address

7800 SW 57TH AVE STE 205
SOUTH MIAMI FL
33143-5542
US

V. Phone/Fax

Practice location:
  • Phone: 305-854-2471
  • Fax: 305-854-0811
Mailing address:
  • Phone: 305-854-2471
  • Fax: 305-854-0811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-24-75790
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: