MEDICARE: DAVID ESCHELBACHER MD PL

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
1	207R00000X	Internal Medicine Physician	ME89859	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DO6871	OTHER	FL	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1992959589
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID ESCHELBACHER MD PL

Provider Business Mailing Address
First Line	:	PO BOX 9155
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33674-9155
Country	:	US
Telephone Number	:	813-957-2465
Fax Number	:	813-374-2495

Provider Business Practice Location Address
First Line	:	2812 N 22ND ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33605-2762
Country	:	US
Telephone Number	:	813-374-2494
Fax Number	:	813-374-2495

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	DAVID J. ESCHELBACHER
Credential	:	MD
Telephone Number	:	813-374-2494

Provider Enumeration Date	:	11/09/2008
Last Update Date	:	04/26/2018

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