Healthcare Provider Details

I. General information

NPI: 1770684904
Provider Name (Legal Business Name): JOSE E ESCALANTE CARDIOLOGY ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 07/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 E 25TH ST STE 214
HIALEAH FL
33013-3850
US

IV. Provider business mailing address

777 E 25TH ST STE 214
HIALEAH FL
33013-3850
US

V. Phone/Fax

Practice location:
  • Phone: 305-836-1997
  • Fax: 305-836-7101
Mailing address:
  • Phone: 305-836-1997
  • Fax: 305-836-7101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME 0059927
License Number StateFL

VIII. Authorized Official

Name: DR. JOSE ENRIQUE ESCALANTE
Title or Position: CARDIOLOGY
Credential: M.D.
Phone: 305-836-1997