Healthcare Provider Details

I. General information

NPI: 1598833808
Provider Name (Legal Business Name): JUAN CARLOS ESTRADA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JC ESTRADA M.D.

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 03/31/2022
Certification Date: 03/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 TVC
NASHVILLE TN
37232-0001
US

IV. Provider business mailing address

3841 GREEN HILLS VILLAGE DR STE 200
NASHVILLE TN
37215-2691
US

V. Phone/Fax

Practice location:
  • Phone: 615-322-3000
  • Fax:
Mailing address:
  • Phone: 615-936-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME83990
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberTN 0000045144
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberME83990
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberTN 0000045144
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: