MEDICARE: KESHANA ESTY

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	372600000X	Adult Companion	FL
2	376J00000X	Homemaker	FL
3	374U00000X	Home Health Aide	FL

General Provider Information

NPI Number	:	1114701117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KESHANA ESTY

Provider Business Mailing Address
First Line	:	14900 SW 30TH ST UNIT 278171
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33027-7234
Country	:	US
Telephone Number	:	305-776-5254
Fax Number	:

Provider Business Practice Location Address
First Line	:	3600 S STATE ROAD 7 STE 1
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33023-5288
Country	:	US
Telephone Number	:	954-842-1981
Fax Number	:	754-209-0630

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

Provider Enumeration Date	:	08/21/2023
Last Update Date	:	09/26/2023

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Directions to “ KESHANA ESTY ” Practice Location

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