Healthcare Provider Details

I. General information

NPI: 1740105683
Provider Name (Legal Business Name): KAILYN ESPANA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 W CAMINO REAL APT 600
BOCA RATON FL
33432-5848
US

IV. Provider business mailing address

1691 FORUM PL # 133
WEST PALM BEACH FL
33401-2336
US

V. Phone/Fax

Practice location:
  • Phone: 513-519-3607
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: