Provider Demographics
NPI:1770684904
Name:JOSE E ESCALANTE CARDIOLOGY ASSOCIATES PA
Entity Type:Organization
Organization Name:JOSE E ESCALANTE CARDIOLOGY ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARDIOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:ENRIQUE
Authorized Official - Last Name:ESCALANTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-836-1997
Mailing Address - Street 1:777 E 25TH ST STE 214
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-3850
Mailing Address - Country:US
Mailing Address - Phone:305-836-1997
Mailing Address - Fax:305-836-7101
Practice Address - Street 1:777 E 25TH ST
Practice Address - Street 2:STE 214
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-3850
Practice Address - Country:US
Practice Address - Phone:305-836-1997
Practice Address - Fax:305-836-7101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 0059927174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL263464300Medicaid
FL263464300Medicaid
FL263464300Medicaid