Provider Demographics
NPI:1013349075
Name:ESCORCIA, BIANCA ROXANA
Entity Type:Individual
Prefix:
First Name:BIANCA
Middle Name:ROXANA
Last Name:ESCORCIA
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 1:15111 SW 63RD TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-2053
Mailing Address - Country:US
Mailing Address - Phone:786-380-8461
Mailing Address - Fax:
Practice Address - Street 1:15111 SW 63RD TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-2053
Practice Address - Country:US
Practice Address - Phone:786-380-8461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5201897164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse