Healthcare Provider Details

I. General information

NPI: 1013036359
Provider Name (Legal Business Name): VICTOR HUGO ESPINOSA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 04/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5458 TOWN CENTER RD STE 17
BOCA RATON FL
33486-1009
US

IV. Provider business mailing address

5458 TOWN CENTER RD STE 17
BOCA RATON FL
33486-1009
US

V. Phone/Fax

Practice location:
  • Phone: 561-465-3507
  • Fax: 561-465-3567
Mailing address:
  • Phone: 561-465-3507
  • Fax: 561-465-3567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberME121742
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberME121742
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: