Provider Demographics
NPI:1588371405
Name:GARCIA ESQUIJAROSA, SONIA
Entity type:Individual
Prefix:
First Name:SONIA
Middle Name:
Last Name:GARCIA ESQUIJAROSA
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 1:3205 6TH ST W
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33971-1083
Mailing Address - Country:US
Mailing Address - Phone:786-916-9011
Mailing Address - Fax:
Practice Address - Street 1:3205 6TH ST W
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33971-1083
Practice Address - Country:US
Practice Address - Phone:786-916-9011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-160623106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRBT-21-160623OtherRBT CERTIFICATION