Healthcare Provider Details

I. General information

NPI: 1164762712
Provider Name (Legal Business Name): VIVIANA ESCOBAR ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2013
Last Update Date: 02/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15680 N KENDALL DR 201
MIAMI FL
33196-1159
US

IV. Provider business mailing address

7000 SW 62ND AVE SUITE 201
SOUTH MIAMI FL
33143-4716
US

V. Phone/Fax

Practice location:
  • Phone: 305-436-9933
  • Fax:
Mailing address:
  • Phone: 305-661-9404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9170656
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: