Provider Demographics
NPI:1518159334
Name:ESCALERA, ALFREDO L (MD)
Entity Type:Individual
Prefix:DR
First Name:ALFREDO
Middle Name:L
Last Name:ESCALERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 5TH STREET VILLAMAR
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979-0979
Mailing Address - Country:US
Mailing Address - Phone:787-531-9290
Mailing Address - Fax:
Practice Address - Street 1:11 CALLE MAR DEL CORAL
Practice Address - Street 2:VILLAMAR
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979-6341
Practice Address - Country:US
Practice Address - Phone:787-531-9290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10436261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRF99381Medicare UPIN