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NPI 1902258544

NPI 1902258544 : SILVIA ESTRADA : MIAMI, FL

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General NPI Number Information
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    NPI Number           |    1902258544
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    Entity Type          |    Individual 
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    Provider Name        |    SILVIA ESTRADA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/07/2016
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    Last Update Date     |    07/07/2016
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Provider Practice Location Address
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    Address Line         |    175 FONTAINEBLEAU BLVD STE 2DI 
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33172-7018
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    Country              |    US
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    Telephone            |    305-228-7000
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    Fax                  |    786-399-9946
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Provider Business Mailing Address
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    Address Line         |    27563 SW 137TH CT 
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    City                 |    HOMESTEAD
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    State                |    FL
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    Zip                  |    33032-7771
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    Country              |    US
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    Telephone            |    305-499-0930
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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        |    103K00000X
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    Taxonomy Name        |    Behavior Analyst
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    License Number       |    E236780547200
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    License Number State |    FL
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