Healthcare Provider Details

I. General information

NPI: 1164016697
Provider Name (Legal Business Name): SANDRA XIMENA ESCOVAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2021
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3830 BEE RIDGE RD STE 200
SARASOTA FL
34233-1105
US

IV. Provider business mailing address

1865 BRICKELL AVE APT A613
MIAMI FL
33129-1631
US

V. Phone/Fax

Practice location:
  • Phone: 941-927-5178
  • Fax:
Mailing address:
  • Phone: 786-280-1850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberME184250
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number24663
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: