Provider Demographics
NPI:1457786535
Name:ESCORBORES, NEIDY C
Entity type:Individual
Prefix:MS
First Name:NEIDY
Middle Name:C
Last Name:ESCORBORES
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 1:2701 CARMEL CT
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-3269
Mailing Address - Country:US
Mailing Address - Phone:407-967-5209
Mailing Address - Fax:407-518-0329
Practice Address - Street 1:2701 CARMEL CT
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34746-3269
Practice Address - Country:US
Practice Address - Phone:407-967-5209
Practice Address - Fax:407-518-0329
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-09
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 14532101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health