MEDICARE: OSVALDO ESQUIVEL IPARRAGUIRRE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	E214640871810	OTHER	FL	DL

General Provider Information

NPI Number	:	1093398166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OSVALDO ESQUIVEL IPARRAGUIRRE

Provider Business Mailing Address
First Line	:	1734 NW 18TH TER
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33993-4955
Country	:	US
Telephone Number	:	239-257-8292
Fax Number	:

Provider Business Practice Location Address
First Line	:	1734 NW 18TH TER
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33993-4955
Country	:	US
Telephone Number	:	239-257-8292
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2021
Last Update Date	:	05/15/2021

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Directions to “ OSVALDO ESQUIVEL IPARRAGUIRRE ” Practice Location

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