Provider Demographics
NPI:1740444132
Name:ESTEBAN ESCOLAR MD PA
Entity type:Organization
Organization Name:ESTEBAN ESCOLAR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ESTEBAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ESCOLAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-763-9666
Mailing Address - Street 1:3175 NE 184TH ST
Mailing Address - Street 2:APT 3104
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33160-2499
Mailing Address - Country:US
Mailing Address - Phone:305-763-9666
Mailing Address - Fax:305-397-2963
Practice Address - Street 1:3175 NE 184TH ST
Practice Address - Street 2:APT 3104
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33160-2499
Practice Address - Country:US
Practice Address - Phone:305-763-9666
Practice Address - Fax:305-397-2963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME99237207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME99237OtherMEDICAL LICENSE