Provider Demographics
NPI:1578789913
Name:MIRELES-ESCARENO, JESUS (MD)
Entity Type:Individual
Prefix:
First Name:JESUS
Middle Name:
Last Name:MIRELES-ESCARENO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6750 E BAYWOOD AVE
Mailing Address - Street 2:SUITE 401
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-1749
Mailing Address - Country:US
Mailing Address - Phone:480-835-7111
Mailing Address - Fax:480-969-9345
Practice Address - Street 1:6750 E BAYWOOD AVE
Practice Address - Street 2:SUITE 401
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-1749
Practice Address - Country:US
Practice Address - Phone:480-835-7111
Practice Address - Fax:480-969-9345
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2021-05-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ43193207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine