Healthcare Provider Details

I. General information

NPI: 1821917113
Provider Name (Legal Business Name): FESCOBAR TELENEUROLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9911 HIGHLAND SKY ALY
ORLANDO FL
32832-6286
US

IV. Provider business mailing address

1032 E BRANDON BLVD # 6015
BRANDON FL
33511-5509
US

V. Phone/Fax

Practice location:
  • Phone: 407-848-8883
  • Fax:
Mailing address:
  • Phone: 407-848-8883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: FREDDY ESCOBAR
Title or Position: OWNER
Credential: MD
Phone: 407-848-8883