Provider Demographics
NPI:1679513154
Name:ESQUENAZI, NADINE I (HIS)
Entity Type:Individual
Prefix:
First Name:NADINE
Middle Name:I
Last Name:ESQUENAZI
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:NADINE
Other - Middle Name:
Other - Last Name:POLLINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BC
Mailing Address - Street 1:2510 E SUNSET RD
Mailing Address - Street 2:UNIT 5-260
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3511
Mailing Address - Country:US
Mailing Address - Phone:702-798-0113
Mailing Address - Fax:866-291-5242
Practice Address - Street 1:269 S. FEDERAL HWY.
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:FL
Practice Address - Zip Code:33441-4161
Practice Address - Country:US
Practice Address - Phone:954-426-2500
Practice Address - Fax:954-426-3797
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2665237700000X
FLAS2665237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL610202600Medicaid