Provider Demographics
NPI:1265862262
Name:ESCANDELL, ISIDRO
Entity Type:Individual
Prefix:
First Name:ISIDRO
Middle Name:
Last Name:ESCANDELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13834 SW 124TH AVENUE RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-6576
Mailing Address - Country:US
Mailing Address - Phone:305-332-4434
Mailing Address - Fax:
Practice Address - Street 1:13834 SW 124TH AVENUE RD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6576
Practice Address - Country:US
Practice Address - Phone:305-332-4434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-13
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals