Healthcare Provider Details

I. General information

NPI: 1255185641
Provider Name (Legal Business Name): ELISEO L ESCOBEDO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2024
Last Update Date: 04/12/2024
Certification Date: 04/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 W SANDUSKY ST
FINDLAY OH
45840-2334
US

IV. Provider business mailing address

1120 W SANDUSKY ST
FINDLAY OH
45840-2334
US

V. Phone/Fax

Practice location:
  • Phone: 419-701-8911
  • Fax:
Mailing address:
  • Phone: 419-701-8911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: