Healthcare Provider Details

I. General information

NPI: 1477427474
Provider Name (Legal Business Name): ESCOBAR MEDICAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2025
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9240 SW 72ND ST STE 241
MIAMI FL
33173-3265
US

IV. Provider business mailing address

18217 SW 148TH AVE RD
MIAMI FL
33187-1883
US

V. Phone/Fax

Practice location:
  • Phone: 305-271-1919
  • Fax: 305-271-1919
Mailing address:
  • Phone: 786-879-6048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MARIA KARLA ESCOBAR
Title or Position: OWNER
Credential:
Phone: 786-879-6048