Healthcare Provider Details

I. General information

NPI: 1235717380
Provider Name (Legal Business Name): ALEXANDRO ESCONTRIAS MSN, APRN, FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 8TH DIVISION RD
COLUMBIA SC
29207-5700
US

IV. Provider business mailing address

114 ASHLEY HALL RD
COLUMBIA SC
29229-9177
US

V. Phone/Fax

Practice location:
  • Phone: 803-751-6789
  • Fax:
Mailing address:
  • Phone: 915-471-5182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1014436
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: