Individual provider Active NPI

Ebram Eskandar, D.O.

  • Student in an Organized Health Care Education/Training Program
  • Tallahassee, FL
National Provider Identifier
1962262113
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1300 Miccosukee Rd
Tallahassee, FL 32308-5054
Phone
(850) 431-7910
NPI assigned
Mar 22, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X FL Primary

Addresses

Primary practice location

1300 Miccosukee Rd
Tallahassee, FL 32308-5054

Mailing address

1300 Miccosukee Rd
Tallahassee, FL 32308-5054
Phone (850) 431-7910

Other names 1

  • Ebram Mamdouh Fathi Eskandar Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240617003171 FL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 5890238950

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1711065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1962262113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 MICCOSUKEE RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085054",
            "telephone_number": "850-431-7910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MICCOSUKEE RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085054",
            "telephone_number": "850-431-7910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESKANDAR",
        "first_name": "EBRAM",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-22",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EBRAM",
            "last_name": "ESKANDAR",
            "middle_name": "MAMDOUH FATHI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.