Healthcare Provider Details

I. General information

NPI: 1962068155
Provider Name (Legal Business Name): LINDSEY SILAS ESCOBAR APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2019
Last Update Date: 05/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1490 TOWN CENTER DR
LAKELAND FL
33803-7965
US

IV. Provider business mailing address

1490 TOWN CENTER DR
LAKELAND FL
33803-7965
US

V. Phone/Fax

Practice location:
  • Phone: 863-904-2500
  • Fax:
Mailing address:
  • Phone: 863-904-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN9355681
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: