Provider Demographics
NPI:1205553799
Name:ESCOTO, KENIA MERCEDES (ARNP FNP-C)
Entity type:Individual
Prefix:
First Name:KENIA
Middle Name:MERCEDES
Last Name:ESCOTO
Suffix:
Gender:F
Credentials:ARNP FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10824 SW 2ND ST APT 115
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-1499
Mailing Address - Country:US
Mailing Address - Phone:786-587-6438
Mailing Address - Fax:
Practice Address - Street 1:10824 SW 2ND ST APT 115
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-1499
Practice Address - Country:US
Practice Address - Phone:786-587-6438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11022454363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty