Healthcare Provider Details

I. General information

NPI: 1265633796
Provider Name (Legal Business Name): LUIS ANTONIO ESCABI SR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 09/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EDIFICIO MEDICO HERMANAS DAVILA SUITE 208 URBANIZACION HERMANAS DAVILA
BAYAMON PR
00959
US

IV. Provider business mailing address

EDIFICIO MEDICO HERMANAS DAVILA SUITE 208 URBANIZACION HERMANAS DAVILA
BAYAMON PR
00959
US

V. Phone/Fax

Practice location:
  • Phone: 787-780-6868
  • Fax: 787-780-6868
Mailing address:
  • Phone: 787-780-6868
  • Fax: 787-780-6868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License Number4074
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: