Provider Demographics
NPI:1396253811
Name:ESQUIVEL, MISLEIDY
Entity type:Individual
Prefix:
First Name:MISLEIDY
Middle Name:
Last Name:ESQUIVEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13070 SW 262ND LN
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-8923
Mailing Address - Country:US
Mailing Address - Phone:786-710-1092
Mailing Address - Fax:
Practice Address - Street 1:13070 SW 262ND LN
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-8923
Practice Address - Country:US
Practice Address - Phone:786-241-1231
Practice Address - Fax:305-256-1663
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-18
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE214540779030OtherLICENSE