Provider Demographics
NPI:1821233032
Name:ESCOBAR RODRIGUEZ, NUBE ROSA (AUD)
Entity Type:Individual
Prefix:
First Name:NUBE
Middle Name:ROSA
Last Name:ESCOBAR RODRIGUEZ
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 N FORT LAUDERDALE BEACH BLVD APT 5A
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33304-4335
Mailing Address - Country:US
Mailing Address - Phone:531-612-8437
Mailing Address - Fax:
Practice Address - Street 1:900 W 49TH ST STE 322
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3407
Practice Address - Country:US
Practice Address - Phone:631-612-8437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-03
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002918231H00000X
NY018842235Z00000X
FLSA 11439235Z00000X
FLAY2341231H00000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist