Provider Demographics
NPI:1760671556
Name:ESCOBAR, SU-NUI (MS, RD/LD)
Entity type:Individual
Prefix:MISS
First Name:SU-NUI
Middle Name:
Last Name:ESCOBAR
Suffix:
Gender:F
Credentials:MS, RD/LD
Other - Prefix:
Other - First Name:SU-NUI
Other - Middle Name:
Other - Last Name:ESCOBAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD/LD
Mailing Address - Street 1:185 SW 7TH ST APT 1707
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-2971
Mailing Address - Country:US
Mailing Address - Phone:786-897-5043
Mailing Address - Fax:
Practice Address - Street 1:185 SW 7TH ST APT 1707
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-2971
Practice Address - Country:US
Practice Address - Phone:786-897-5043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-17
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND4776133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered