Provider Demographics
NPI:1629059621
Name:ESCALONA LOUBRIEL, PEDRO RAFAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:RAFAEL
Last Name:ESCALONA LOUBRIEL
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 1:268 CALLE MIRAMAR
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682-5836
Mailing Address - Country:US
Mailing Address - Phone:787-265-2250
Mailing Address - Fax:
Practice Address - Street 1:#416 CALLE BETANCES(POST)
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-265-2250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8122207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0081345Medicare ID - Type Unspecified
PRE09385Medicare UPIN