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NPI Code Detail

MEDICARE: DUSTIN ESPINOSA LMT

MEDICARE: DUSTIN ESPINOSA LMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage TherapistMA102042FL

General Provider Information

NPI Number : 1790517183
Entity Type Code : Individual
Provider Name (Legal Business Name) : DUSTIN ESPINOSA LMT
Provider Business Mailing Address
First Line : 9785 CROSSHILL BLVD STE 108
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32222-5889
Country : US
Telephone Number : 904-772-6522
Fax Number : 904-772-6553
Provider Business Practice Location Address
First Line : 9785 CROSSHILL BLVD STE 108
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32222-5889
Country : US
Telephone Number : 904-772-6522
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2024
Last Update Date : 08/15/2024

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Directions to “ DUSTIN ESPINOSA LMT” Practice Location

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