Provider Demographics
NPI:1275611287
Name:ESTAPE, ERIC MANUEL (ARNP)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:MANUEL
Last Name:ESTAPE
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 SW 87TH AVE STE 130A
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3637
Mailing Address - Country:US
Mailing Address - Phone:305-666-1811
Mailing Address - Fax:305-666-1801
Practice Address - Street 1:7800 SW 87TH AVE STE 130A
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3637
Practice Address - Country:US
Practice Address - Phone:305-666-1811
Practice Address - Fax:305-666-1801
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2568672363LA2200X
FLAPRN2568672363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health