Provider Demographics
NPI:1578166427
Name:ESCALONA - CABRERA, KENIA (APRN)
Entity Type:Individual
Prefix:
First Name:KENIA
Middle Name:
Last Name:ESCALONA - CABRERA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11041 SW 241ST ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-5103
Mailing Address - Country:US
Mailing Address - Phone:786-720-7016
Mailing Address - Fax:
Practice Address - Street 1:11041 SW 241ST ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-5103
Practice Address - Country:US
Practice Address - Phone:786-720-7016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11010183363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care