Provider Demographics
NPI:1699196667
Name:ESQUIVEL, MARCELA (INTERN)
Entity Type:Individual
Prefix:
First Name:MARCELA
Middle Name:
Last Name:ESQUIVEL
Suffix:
Gender:F
Credentials:INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9011 TUSCAN VALLEY PL
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-7578
Mailing Address - Country:US
Mailing Address - Phone:321-626-2186
Mailing Address - Fax:
Practice Address - Street 1:2940 PLEASANT HILL RD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34746-3061
Practice Address - Country:US
Practice Address - Phone:407-846-0023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-18
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health