Provider Demographics
NPI:1396001350
Name:ESCRIBANO, JOHAN EMANUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHAN
Middle Name:EMANUEL
Last Name:ESCRIBANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOHAN
Other - Middle Name:EMANUEL
Other - Last Name:ESCRIBANO-FONTANET
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:8010 SUMMERLIN LAKES DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1849
Mailing Address - Country:US
Mailing Address - Phone:239-939-1767
Mailing Address - Fax:239-939-5895
Practice Address - Street 1:8010 SUMMERLIN LAKES DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-1849
Practice Address - Country:US
Practice Address - Phone:239-939-1767
Practice Address - Fax:399-395-8952
Is Sole Proprietor?:No
Enumeration Date:2012-04-04
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME139206208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery