Healthcare Provider Details

I. General information

NPI: 1053964049
Provider Name (Legal Business Name): JOHN ESCANO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2019
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3557 EMBASSY PKWY
FAIRLAWN OH
44333-8358
US

IV. Provider business mailing address

2607 KINGSTON RD
CLEVELAND OH
44118-4309
US

V. Phone/Fax

Practice location:
  • Phone: 330-670-1005
  • Fax:
Mailing address:
  • Phone: 440-749-9452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number106249
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN.CRNA.0020381
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number287682
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: