Healthcare Provider Details

I. General information

NPI: 1871564021
Provider Name (Legal Business Name): BOBBY ESCOE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 02/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8787 BRYAN DAIRY RD
LARGO FL
33777-1251
US

IV. Provider business mailing address

PO BOX 862155
ORLANDO FL
32886-2155
US

V. Phone/Fax

Practice location:
  • Phone: 727-394-5300
  • Fax:
Mailing address:
  • Phone: 913-647-0593
  • Fax: 913-341-5797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberOS0005555
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: