Provider Demographics
NPI:1477092674
Name:ESCALONA, ISAEL SR
Entity Type:Individual
Prefix:
First Name:ISAEL
Middle Name:
Last Name:ESCALONA
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9800 HAITIAN DR
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-1612
Mailing Address - Country:US
Mailing Address - Phone:786-302-5303
Mailing Address - Fax:786-701-2904
Practice Address - Street 1:9800 HAITIAN DR
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-1612
Practice Address - Country:US
Practice Address - Phone:786-302-5303
Practice Address - Fax:786-701-2904
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-21
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician