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General NPI Number Information
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NPI Number | 1699406108
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Entity Type | Individual
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Provider Name | MELANIE ESCOBAR
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Gender | Female
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Dates
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Enumeration Date | 06/23/2022
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 10790 OLD SAINT AUGUSTINE RD
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City | JACKSONVILLE
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State | FL
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Zip | 32257-1078
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Country | US
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Telephone | 904-260-0800
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Fax |
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Provider Business Mailing Address
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Address Line | 3010 OATLAND CT
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City | ORANGE PARK
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State | FL
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Zip | 32065-2203
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Country | US
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Telephone | 904-434-3644
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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 | 2251E1300X
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Taxonomy Name | Clinical Electrophysiology Physical Therapist
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License Number | PT8389
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License Number State | FL
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