MEDICARE: ESPINO & ESPINO, P.A.

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
1	174400000X	Specialist

General Provider Information

NPI Number	:	1932103793
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ESPINO & ESPINO, P.A.

Provider Business Mailing Address
First Line	:	2315 PARK ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204-4317
Country	:	US
Telephone Number	:	904-387-3124
Fax Number	:

Provider Business Practice Location Address
First Line	:	2315 PARK ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204-4317
Country	:	US
Telephone Number	:	904-387-3124
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	GONZALO A. ESPINO
Credential	:	M.D., M.S.A.
Telephone Number	:	904-387-3124

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	08/22/2020

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