Provider Demographics
NPI:1558301440
Name:ESCOBAR RODRIGUEZ, PEDRO F (MD)
Entity type:Individual
Prefix:
First Name:PEDRO
Middle Name:F
Last Name:ESCOBAR RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1492 AVE PONCE DE LEON STE 718
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-4024
Mailing Address - Country:US
Mailing Address - Phone:787-300-5555
Mailing Address - Fax:787-300-5554
Practice Address - Street 1:1492 AVE PONCE DE LEON STE 718
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-4024
Practice Address - Country:US
Practice Address - Phone:787-300-5555
Practice Address - Fax:787-300-5554
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16410207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2343539Medicaid
OHH90416Medicare UPIN
OH7349421Medicare PIN