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General NPI Number Information
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NPI Number | 1750027330
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Entity Type | Individual
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Provider Name | PRISCILA STEPHANIE ESCAMILLA ITDS
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Gender | Female
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Dates
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Enumeration Date | 05/07/2022
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 1601 NW 12TH AVE # D-820
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City | MIAMI
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State | FL
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Zip | 33136-1005
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Country | US
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Telephone | 305-243-6660
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Fax |
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Provider Business Mailing Address
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Address Line | 3645 NW 36TH ST APT 712
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City | MIAMI
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State | FL
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Zip | 33142-4985
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Country | US
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Telephone | 786-795-1645
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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