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General NPI Number Information
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NPI Number | 1023631090
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Entity Type | Individual
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Provider Name | VICMA FLOR ESCALANTE ZERPA PA DERMATOLOGY
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Gender | Female
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Dates
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Enumeration Date | 05/25/2020
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 2030 S DOUGLAS RD STE 216
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City | CORAL GABLES
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State | FL
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Zip | 33134-4620
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Country | US
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Telephone | 305-610-0585
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Fax |
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Provider Business Mailing Address
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Address Line | 2935 SW 60TH CT
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City | MIAMI
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State | FL
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Zip | 33155-4046
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Country | US
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Telephone | 786-302-0934
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 2064-PA
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PACN38
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 14-518
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | TPPA669
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License Number State | FL
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