Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | ME27676 | FL |
NPI | 1275519480 |
---|---|
Provider Name | Dr. Juan A Escobales |
First Address | St Petersburg, FL 33713-8603 |
Second Address | St Petersburg, FL 33713-8603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2005 |
Last Update Date | 13/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
057369800 | (05) | FL |
D56326 | (02) | FL |