Healthcare Provider Details

I. General information

NPI: 1558301440
Provider Name (Legal Business Name): PEDRO F. ESCOBAR RODRIGUEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1492 AVE PONCE DE LEON STE 718
SAN JUAN PR
00907-4024
US

IV. Provider business mailing address

1492 AVE PONCE DE LEON STE 718
SAN JUAN PR
00907-4024
US

V. Phone/Fax

Practice location:
  • Phone: 787-300-5555
  • Fax: 787-300-5554
Mailing address:
  • Phone: 787-300-5555
  • Fax: 787-300-5554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number16410
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: