Provider Demographics
NPI:1760548895
Name:ESCALONA, JAIME JOSE (DPM)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:JOSE
Last Name:ESCALONA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:B3 CALLE 1
Mailing Address - Street 2:VILLAS DE SAN FRANCISCO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-6449
Mailing Address - Country:US
Mailing Address - Phone:787-764-8798
Mailing Address - Fax:787-763-2696
Practice Address - Street 1:124 AVE WINSTON CHURCHILL
Practice Address - Street 2:SUITE 4
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-6064
Practice Address - Country:US
Practice Address - Phone:787-764-8798
Practice Address - Fax:787-763-2696
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR071213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRU63106Medicare UPIN
PR48081Medicare ID - Type Unspecified