Healthcare Provider Details

I. General information

NPI: 1528885340
Provider Name (Legal Business Name): INDIA ESGUERRA MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2024
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2660 CYPRESS RIDGE BLVD STE 101
WESLEY CHAPEL FL
33544-6324
US

IV. Provider business mailing address

11063 LITTLE BLUE HERON DR
RIVERVIEW FL
33579-2419
US

V. Phone/Fax

Practice location:
  • Phone: 813-994-4440
  • Fax: 813-973-1254
Mailing address:
  • Phone: 904-322-6613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: