Provider Demographics
NPI:1356231609
Name:ESCOBAR, MADELAINE DELOS SANTOS
Entity type:Individual
Prefix:
First Name:MADELAINE
Middle Name:DELOS SANTOS
Last Name:ESCOBAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 JONES ST
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-6358
Mailing Address - Country:US
Mailing Address - Phone:757-785-6824
Mailing Address - Fax:
Practice Address - Street 1:216 JONES ST
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-6358
Practice Address - Country:US
Practice Address - Phone:757-785-6824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
20253143P374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty