Provider Demographics
NPI:1790559128
Name:RUISANCHEZ ESCARRA, JHUNIOR
Entity Type:Individual
Prefix:
First Name:JHUNIOR
Middle Name:
Last Name:RUISANCHEZ ESCARRA
Suffix:
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 1:1441 SW 26TH AVE APT E
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8050
Mailing Address - Country:US
Mailing Address - Phone:973-508-0498
Mailing Address - Fax:
Practice Address - Street 1:4793 N CONGRESS AVE STE 203
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-7937
Practice Address - Country:US
Practice Address - Phone:561-722-9107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-07
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician