1962544601 NPI number — MS. ADRIANA PATRICIA ESCUDERO CRNA

Table of content: MS. ADRIANA PATRICIA ESCUDERO CRNA (NPI 1962544601)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962544601 NPI number — MS. ADRIANA PATRICIA ESCUDERO CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ESCUDERO
Provider First Name:
ADRIANA
Provider Middle Name:
PATRICIA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1962544601
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/19/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7111 FAIRWAY DRIVE, SUITE 202
Provider Second Line Business Mailing Address:
HIALEAH ANESTHESIA SPECIALIST
Provider Business Mailing Address City Name:
PALM BEACH GARDENS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33418
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-799-3552
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7111 FAIRWAY DRIVE, SUITE 202
Provider Second Line Business Practice Location Address:
HIALEAH ANESTHESIA SPECIALIST
Provider Business Practice Location Address City Name:
PALM BEACH GARDENS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33418
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-799-3552
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  3196162 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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