MEDICARE: CHRISTINA ROCHELLE ESCALANTE MD

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	89680	GA

General Provider Information

NPI Number	:	1881123891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA ROCHELLE ESCALANTE MD

Provider Business Mailing Address
First Line	:	11090 SERENBE LN STE 320
Second Line	:
City	:	PALMETTO
State	:	GA
Zip	:	30268-2474
Country	:	US
Telephone Number	:	470-450-4729
Fax Number	:	470-275-0895

Provider Business Practice Location Address
First Line	:	11090 SERENBE LN STE 320
Second Line	:
City	:	PALMETTO
State	:	GA
Zip	:	30268-2474
Country	:	US
Telephone Number	:	470-450-4729
Fax Number	:	470-275-0895

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2017
Last Update Date	:	11/13/2024

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