Healthcare Provider Details

I. General information

NPI: 1831172998
Provider Name (Legal Business Name): L FRANCISCO ESPAILLAT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: LUIS FRANCISCO ESPAILLAT MD

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 08/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 US 27 S
AVON PARK FL
33825-9701
US

IV. Provider business mailing address

2234 COLONIAL BLVD ATTN: PAYER CONTRACTING & RELATIONS DEPT.
FORT MYERS FL
33907-1412
US

V. Phone/Fax

Practice location:
  • Phone: 863-382-6108
  • Fax: 863-382-2182
Mailing address:
  • Phone: 239-931-7342
  • Fax: 239-931-7385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME37822
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: