Provider Demographics
NPI:1679560734
Name:ESTRADA, NAPOLEON N (MD)
Entity Type:Individual
Prefix:
First Name:NAPOLEON
Middle Name:N
Last Name:ESTRADA
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 1:320 W BASS ST
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-5001
Mailing Address - Country:US
Mailing Address - Phone:407-846-3166
Mailing Address - Fax:407-846-0019
Practice Address - Street 1:320 W BASS ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-5001
Practice Address - Country:US
Practice Address - Phone:407-846-3166
Practice Address - Fax:407-846-0019
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0046898208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL043060900Medicaid
FL1679560734Medicare PIN
FLD82460Medicare UPIN