Healthcare Provider Details

I. General information

NPI: 1578287942
Provider Name (Legal Business Name): BOTROS ESKAROUS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2022
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9332 STATE ROAD 54
TRINITY FL
34655-1810
US

IV. Provider business mailing address

9332 STATE ROAD 54
TRINITY FL
34655-1810
US

V. Phone/Fax

Practice location:
  • Phone: 727-834-4868
  • Fax: 727-816-2868
Mailing address:
  • Phone: 727-834-4868
  • Fax: 727-816-2868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH26586
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: