MEDICARE: DR. DIEGO ESCOBAR 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	207R00000X	Internal Medicine Physician	236217	NY
2	2083P0011X	Undersea and Hyperbaric Medicine (Preventive Medicine) Physician	ME156375	FL

General Provider Information

NPI Number	:	1881622181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DIEGO ESCOBAR MD

Provider Business Mailing Address
First Line	:	6989 E FOWLER AVE
Second Line	:
City	:	TEMPLE TERRACE
State	:	FL
Zip	:	33617-1714
Country	:	US
Telephone Number	:	813-935-4210
Fax Number	:	813-932-1503

Provider Business Practice Location Address
First Line	:	3000 MEDICAL PARK DR STE 430
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-4681
Country	:	US
Telephone Number	:	813-615-7160
Fax Number	:	813-615-7173

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

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	04/11/2024

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