Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | ME63992 | FL |
NPI | 1013943075 |
---|---|
Provider Name | Dr. Rudy Escarria |
First Address | Wellington, FL 33414-8813 |
Second Address | Riviera Beach, FL 33410-7417 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
VADOO | (02) | FL |