Healthcare Provider Details

I. General information

NPI: 1104929025
Provider Name (Legal Business Name): JOSE ENRIQUE ESCALANTE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 EAST 25TH STREET SUITE #214
HIALEAH FL
33013
US

IV. Provider business mailing address

777 EAST 25TH STREET SUITE #214
HIALEAH FL
33013
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 Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME59927
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: