Healthcare Provider Details

I. General information

NPI: 1497287411
Provider Name (Legal Business Name): MEGHAN ESCEBEDO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2017
Last Update Date: 03/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 N 14TH ST
LEESBURG FL
34748-3850
US

IV. Provider business mailing address

1004 N 14TH ST
LEESBURG FL
34748-3850
US

V. Phone/Fax

Practice location:
  • Phone: 352-561-3180
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberAS 5250
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: