Provider Demographics
NPI:1114701117
Name:ESTY, KESHANA
Entity Type:Individual
Prefix:
First Name:KESHANA
Middle Name:
Last Name:ESTY
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 1:14900 SW 30TH ST UNIT 278171
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-7234
Mailing Address - Country:US
Mailing Address - Phone:305-776-5254
Mailing Address - Fax:
Practice Address - Street 1:3600 S STATE ROAD 7 STE 1
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-5288
Practice Address - Country:US
Practice Address - Phone:954-842-1981
Practice Address - Fax:754-209-0630
Is Sole Proprietor?:No
Enumeration Date:2023-08-21
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL372600000X, 376J00000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No372600000XNursing Service Related ProvidersAdult Companion
No376J00000XNursing Service Related ProvidersHomemaker