Healthcare Provider Details

I. General information

NPI: 1013612720
Provider Name (Legal Business Name): DANIEL ESCALONA ESCALONA APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 05/23/2023
Certification Date: 04/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4160 N ARMENIA AVE STE A
TAMPA FL
33607-6453
US

IV. Provider business mailing address

9655 JASMINE BROOK CIR
LAND O LAKES FL
34638-6028
US

V. Phone/Fax

Practice location:
  • Phone: 855-226-6633
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberAPRN11025455
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11025455
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: