Provider Demographics
NPI:1700019171
Name:ESCOBAR, ROSA ELVIRA
Entity Type:Individual
Prefix:MS
First Name:ROSA
Middle Name:ELVIRA
Last Name:ESCOBAR
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 1:3201 CORAL SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-3803
Mailing Address - Country:US
Mailing Address - Phone:561-452-4030
Mailing Address - Fax:
Practice Address - Street 1:299 CAMINO GARDENS BLVD
Practice Address - Street 2:THE BOCA CENTER FOR HEALING SUITE 101
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-5822
Practice Address - Country:US
Practice Address - Phone:561-452-4030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA52053225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist