MEDICARE: ACORN TO OAK HEALTH, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207R00000X	Internal Medicine Physician
2	208000000X	Pediatrics Physician
3	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1689418832
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACORN TO OAK HEALTH, LLC

Provider Business Mailing Address
First Line	:	272 MADO LN
Second Line	:
City	:	CHATTAHOOCHEE HILLS
State	:	GA
Zip	:	30268-2391
Country	:	US
Telephone Number	:	352-318-5487
Fax Number	:

Provider Business Practice Location Address
First Line	:	11090 SERENBE LN STE 320
Second Line	:
City	:	CHATTAHOOCHEE HILLS
State	:	GA
Zip	:	30268-2474
Country	:	US
Telephone Number	:	352-318-5487
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CHRISTINA R ESCALANTE
Credential	:	MD
Telephone Number	:	352-318-5487

Provider Enumeration Date	:	06/22/2024
Last Update Date	:	07/01/2024

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