Provider Demographics
NPI:1548155708
Name:ESIS, ELIANA G
Entity type:Individual
Prefix:MRS
First Name:ELIANA
Middle Name:G
Last Name:ESIS
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 1:10401 NW 82ND ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-4085
Mailing Address - Country:US
Mailing Address - Phone:305-496-1220
Mailing Address - Fax:
Practice Address - Street 1:10401 NW 82ND ST UNIT 1
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-4085
Practice Address - Country:US
Practice Address - Phone:305-496-1220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBACB1032936106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician