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General NPI Number Information
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NPI Number | 1831185602
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Entity Type | Individual
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Provider Name | LUIS ALCIDES ESCOBAR MD
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Gender | Male
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Dates
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Enumeration Date | 09/27/2005
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Last Update Date | 06/21/2024
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Provider Practice Location Address
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Address Line | 4350 SHERIDAN ST STE 102
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City | HOLLYWOOD
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State | FL
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Zip | 33021-3556
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Country | US
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Telephone | 954-322-8586
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Fax | 954-322-8581
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Provider Business Mailing Address
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Address Line | 3510 NE 23RD AVE
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City | LIGHTHOUSE POINT
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State | FL
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Zip | 33064-8129
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Country | US
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Telephone | 954-322-8586
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Fax | 954-322-8581
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | ME58000
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | ME58000
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License Number State | FL
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