Provider Demographics
NPI:1699194944
Name:ESQUILLA, JUJI TEJARES (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:JUJI
Middle Name:TEJARES
Last Name:ESQUILLA
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 W FAIRBANKS AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4756
Mailing Address - Country:US
Mailing Address - Phone:321-843-5851
Mailing Address - Fax:321-842-1611
Practice Address - Street 1:1111 W FAIRBANKS AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4756
Practice Address - Country:US
Practice Address - Phone:321-843-5851
Practice Address - Fax:321-842-1611
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9205665363LF0000X
FLAPRN9205665363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL125201200Medicaid