Healthcare Provider Details

I. General information

NPI: 1306230313
Provider Name (Legal Business Name): ENRIQUE ESCOFET DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2015
Last Update Date: 03/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 CORAL WAY SUITE 203
MIAMI FL
33145-2929
US

IV. Provider business mailing address

1330 CORAL WAY SUITE 203
MIAMI FL
33145-2929
US

V. Phone/Fax

Practice location:
  • Phone: 305-858-6085
  • Fax: 305-854-7004
Mailing address:
  • Phone: 305-858-6085
  • Fax: 305-854-7004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN0013770
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: