Healthcare Provider Details

I. General information

NPI: 1043540297
Provider Name (Legal Business Name): CARLOS ESCALANTE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2010
Last Update Date: 01/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CHARDON AVE ANGEL RAMOS FOUNDATION BL APS HEALTHCARE PR
SAN JUAN PR
00918
US

IV. Provider business mailing address

PO BOX 71474 APS HEALTHCARE PR
SAN JUAN PR
00936-8574
US

V. Phone/Fax

Practice location:
  • Phone: 787-641-0773
  • Fax: 787-641-0776
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2470A2800X
TaxonomyAssistant Health Information Record Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: