Provider Demographics
NPI:1790335842
Name:SKILLED CARE SPECIALISTS INC
Entity Type:Organization
Organization Name:SKILLED CARE SPECIALISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ESTEBAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:JANOLO
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:407-344-3933
Mailing Address - Street 1:203 WESTMORELAND CIR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-5463
Mailing Address - Country:US
Mailing Address - Phone:407-344-3933
Mailing Address - Fax:
Practice Address - Street 1:203 WESTMORELAND CIR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-5463
Practice Address - Country:US
Practice Address - Phone:407-344-3933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-19
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty