Healthcare Provider Details

I. General information

NPI: 1932967221
Provider Name (Legal Business Name): ESCRIBA MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2024
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11925 SOUTHERN BLVD STE 3
ROYAL PALM BEACH FL
33411-7672
US

IV. Provider business mailing address

11925 SOUTHERN BLVD STE 3
ROYAL PALM BEACH FL
33411-7672
US

V. Phone/Fax

Practice location:
  • Phone: 773-364-0750
  • Fax:
Mailing address:
  • Phone: 773-639-8651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ABELARDO ESCRIBA OMAR
Title or Position: MD
Credential: MD
Phone: 773-639-8651