Provider Demographics
NPI:1336656164
Name:ESCALERA MOLINA, CHRISTIAN GIOVANNY SR
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:GIOVANNY
Last Name:ESCALERA MOLINA
Suffix:SR
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:URB VILLA PINARES
Mailing Address - Street 2:PASEO CALMA 139
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693
Mailing Address - Country:US
Mailing Address - Phone:787-226-4670
Mailing Address - Fax:
Practice Address - Street 1:URB. VILLA PINARES
Practice Address - Street 2:PASEO CALMA 139
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693
Practice Address - Country:US
Practice Address - Phone:787-226-4670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-02
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2036235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty