NPIMap

Individual provider Active NPI

Juan Carlos Escandon, MD

  • Family Medicine Physician
  • Davenport, FL
National Provider Identifier
1356567788
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME109282 Issued in FL
Practice address
130 Ridge Center Dr Ste 104
Davenport, FL 33837-6414
Phone
(863) 421-9447
Fax
(863) 421-1806
NPI assigned
Apr 17, 2007
Last updated
Sep 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME109282 FL Primary
Sleep Medicine (Family Medicine) Physician 207QS1201X ME109282 FL

Addresses

Primary practice location

130 Ridge Center Dr Ste 104
Davenport, FL 33837-6414

Mailing address

6675 Westwood Blvd Ste 475
Orlando, FL 32821-6027
Phone (407) 845-0330

Other identifiers 1

IdentifierTypeStateIssuer
ME109282OtherFLMEDICINE DOCTOR LIC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110923000534 FL Practitioner - Family Practice 7416084546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Home Alliance, LLCGroup PAC ID 6406096536, 60 clinicians

Practice addresses (Care Compare)

130 Ridge Ctr Dr
Suite 104
Davenport, FL 33837-6414
Phone (863) 421-9447

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME109282FLMDSleep Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Home Alliance LLC CurrentSince Dec 21, 2025 Accepting new patients
Medical Home Alliance LLC CurrentSince Jan 28, 2021 Accepting new patients
Medical Home Alliance LLC Past Accepting new patients
Bja Incorporated PastSince Dec 6, 2012 Accepting new patients
Bja Incorporated Past Accepting new patients

Locations

111 Webb Dr
Davenport, FL 33837
Phone (863) 421-9447

111 Webb Dr
Ste 475
Davenport, FL 33837

130 Ridge Center Dr
Ste 104
Davenport, FL 33837
Phone (863) 421-9447

6675 Westwood Blvd
Ste 475
Orlando, FL 32821
Phone (407) 845-0384

199 Avenue K SE
Winter Haven, FL 33880
Phone (563) 588-1424

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1356567788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6675 WESTWOOD BLVD STE 475",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328216027",
            "telephone_number": "407-845-0330",
            "fax_number": "888-972-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 RIDGE CENTER DR STE 104",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338376414",
            "telephone_number": "863-421-9447",
            "fax_number": "863-421-1806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESCANDON",
        "first_name": "JUAN",
        "middle_name": "CARLOS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME109282",
            "primary": true
        },
        {
            "code": "207QS1201X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sleep Medicine",
            "state": "FL",
            "license": "ME109282",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICINE DOCTOR LIC",
            "identifier": "ME109282",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, FL

Sources for this page

Verify at the official NPI Registry.