MEDICARE: DINA MARIA ESCOBAR

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	106E00000X	Assistant Behavior Analyst

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942710207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DINA MARIA ESCOBAR

Provider Business Mailing Address
First Line	:	1890 NW 24TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125-1258
Country	:	US
Telephone Number	:	786-768-8367
Fax Number	:

Provider Business Practice Location Address
First Line	:	1890 NW 24TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125-1258
Country	:	US
Telephone Number	:	786-768-9367
Fax Number	:	786-768-9367

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

Provider Enumeration Date	:	10/01/2017
Last Update Date	:	10/01/2017

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Directions to “ DINA MARIA ESCOBAR ” Practice Location

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