Healthcare Provider Details

I. General information

NPI: 1114483583
Provider Name (Legal Business Name): PETER ESKANDER ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2019
Last Update Date: 01/21/2020
Certification Date: 01/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17512 DONA MICHELLE DR
TAMPA FL
33647-3265
US

IV. Provider business mailing address

7658 POOL COMPASS LOOP
WESLEY CHAPEL FL
33545-5271
US

V. Phone/Fax

Practice location:
  • Phone: 813-533-3494
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11001538
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: