Individual
IVAN DARIO ESCOBAR ROLDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5325 26TH ST W, BRADENTON, FL 34207-3012
(941) 752-7173
(941) 567-6277
Mailing address
101 RIVERFRONT BLVD STE 710, BRADENTON, FL 34205-8812
(941) 776-4000
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
237864
NC
2084P0800X
Psychiatry Physician
Primary
ME155308
FL
246YC3302X
Physician Office Based Coding Specialist
—
—
390200000X
Student in an Organized Health Care Education/Training Program
237864
NC
Other
Enumeration date
07/27/2018
Last updated
07/12/2022
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