Provider Demographics
NPI:1326674383
Name:ESCOBAR, FREDDY ALONSO (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDDY
Middle Name:ALONSO
Last Name:ESCOBAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:FREDDY
Other - Middle Name:ALONSO
Other - Last Name:ESCOBAR-MONTEALEGRE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:720 W OAK ST STE 201
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4998
Mailing Address - Country:US
Mailing Address - Phone:407-518-2702
Mailing Address - Fax:
Practice Address - Street 1:720 W OAK ST STE 201
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4998
Practice Address - Country:US
Practice Address - Phone:407-518-2702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-20
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program