Healthcare Provider Details

I. General information

NPI: 1891965158
Provider Name (Legal Business Name): ESTEBAN ESCOLAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2008
Last Update Date: 11/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 ALTON RD BUTLER BULDING
MIAMI BEACH FL
33140-2800
US

IV. Provider business mailing address

3175 NE 184TH ST #3104
AVENTURA FL
33160-2499
US

V. Phone/Fax

Practice location:
  • Phone: 305-674-2049
  • Fax: 305-397-2963
Mailing address:
  • Phone: 305-933-1036
  • Fax: 305-397-2963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME99237
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME99237
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: