Healthcare Provider Details

I. General information

NPI: 1942713797
Provider Name (Legal Business Name): ANIELKA ESCOTO ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2017
Last Update Date: 04/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11750 BIRD RD
MIAMI FL
33175-3530
US

IV. Provider business mailing address

PO BOX 3725
AUGUSTA GA
30914-3725
US

V. Phone/Fax

Practice location:
  • Phone: 706-863-9595
  • Fax: 706-868-8375
Mailing address:
  • Phone: 706-863-9595
  • Fax: 706-868-8375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9283850
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: