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NPI Code Detail

MEDICARE: STEPHANIE ESCRUCERIA DO

MEDICARE:   STEPHANIE  ESCRUCERIA  DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1558209544
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE ESCRUCERIA DO
Provider Business Mailing Address
First Line : 4725 N FEDERAL HWY
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33308-4603
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4725 N FEDERAL HWY
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33308-4603
Country : US
Telephone Number : 954-542-3359
Fax Number : 954-542-5790
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2026
Last Update Date : 03/23/2026

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Directions to “ STEPHANIE ESCRUCERIA DO” Practice Location

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