Provider Demographics
NPI:1366113128
Name:ESCOTO, AMANDA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:
Last Name:ESCOTO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11860 SW 181ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-2423
Mailing Address - Country:US
Mailing Address - Phone:786-486-6323
Mailing Address - Fax:
Practice Address - Street 1:12711 SW 200TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-4804
Practice Address - Country:US
Practice Address - Phone:305-506-0562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-22
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL63269183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist