Healthcare Provider Details

I. General information

NPI: 1700557071
Provider Name (Legal Business Name): LEIDY ESCOBAR APRN-CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2021
Last Update Date: 02/26/2024
Certification Date: 02/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 SW 73RD ST
SOUTH MIAMI FL
33143-4679
US

IV. Provider business mailing address

7350 SW 83RD CT
MIAMI FL
33143-3822
US

V. Phone/Fax

Practice location:
  • Phone: 786-436-1231
  • Fax:
Mailing address:
  • Phone: 786-436-1231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11030745
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: