Individual
CONSUELO R ESCALONA FONSECA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5190 NW 167TH ST STE 309, MIAMI LAKES, FL 33014-6338
(929) 330-5902
Mailing address
5190 NW 167TH ST STE 309, MIAMI LAKES, FL 33014-6338
(929) 330-5902
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CBHCBMDS101045
FL
Other
Enumeration date
02/10/2021
Last updated
02/10/2021
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