Healthcare Provider Details

I. General information

NPI: 1770852410
Provider Name (Legal Business Name): CARLOS ESCASENA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2011
Last Update Date: 04/14/2021
Certification Date: 04/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 S DOUGLAS RD STE 301
CORAL GABLES FL
33134-6104
US

IV. Provider business mailing address

2550 S DOUGLAS RD STE 301
CORAL GABLES FL
33134-6104
US

V. Phone/Fax

Practice location:
  • Phone: 305-588-7170
  • Fax: 305-640-5261
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME124125
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: